Visual–motor integration and fine motor skills at 6½ years of age and associations with neonatal brain volumes in children born extremely preterm in Sweden: a population-based cohort study

Bolk, Jenny; Padilla, Nelly; Forsman, Lea; Broström, Lina; Hellgren, Karin; Ådén, Ulrika

doi:10.1136/bmjopen-2017-020478

Cited by 33 publications

(30 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An increasing body of research targeting the consequences of PT birth indicates cascading disruption to neurological development, [1][2][3][4][5][6] with the degree of deficits correlating with degree of prematurity. [7][8][9][10][11][12][13][14] Specifically, converging findings from animal models along with human neuroimaging investigations indicate that early disruption to white and gray matter development resulting from PT birth is largely responsible for inducing disruption of cognitive development [15][16][17][18][19] and psychopathologies. [20][21][22] Brain plasticity-the way experiences shape neural wiring of the brain-is thought to be one of the primary mechanisms through which humans adapt to environmental change and demonstrate resilience to adverse events.…”

Section: Introductionmentioning

confidence: 99%

Nurturing the preterm infant brain: leveraging neuroplasticity to improve neurobehavioral outcomes

et al. 2018

View full text Add to dashboard Cite

An intrinsic feature of the developing brain is high susceptibility to environmental influence-known as plasticity. Research indicates cascading disruption to neurological development following preterm (PT) birth; yet, the interactive effects of PT birth and plasticity remain unclear. It is possible that, with regard to neuropsychological outcomes in the PT population, plasticity is a doubleedged sword. On one side, high plasticity of rapidly developing neural tissue makes the PT brain more vulnerable to injury resulting from events, including inflammation, hypoxia, and ischemia. On the other side, plasticity may be a mechanism through which positive experience can normalize neurological development for PT children. Much of the available literature on PT neurological development is clinically weighted and focused on diagnostic utility for predicting long-term outcomes. Although diagnostic utility is valuable, research establishing neuroprotective factors is equally beneficial. This review will: (1) detail specific mechanisms through which plasticity is adaptive or maladaptive depending on the experience; (2) integrate research from neuroimaging, intervention, and clinical science fields in a summary of findings suggesting inherent plasticity of the PT brain as a mechanism to improve child outcomes; and (3) summarize how responsive caregiving experiences situate parents as agents of change in normalizing PT infant brain development.

show abstract

Section: Introductionmentioning

confidence: 99%

Nurturing the preterm infant brain: leveraging neuroplasticity to improve neurobehavioral outcomes

et al. 2018

View full text Add to dashboard Cite

show abstract

“…A randomised controlled trial (RCT) showed preterm infants <33 weeks receiving a mean of 32 s DCC compared with a mean of ECC 6.6 s had better motor function at 18–22 months corrected age 9. In infants <27 weeks, areas of the brain responsible for visual motor integration and fine motor skills are known to be particularly vulnerable to injury, with resultant functional deficits noted 6.5 years later 10. Effective spontaneous ventilation for optimal cardiopulmonary transition in the majority of very preterm infants appears to occur more than a minute or two after birth; thus, timing is relevant to the physiology of transition.…”

mentioning

confidence: 99%

Haematocrit in <35 weeks preterm infants who received at least 60 seconds of delayed cord clamping: a retrospective observational study

Nudelman¹,

Goel

Jegatheesan

et al. 2019

bmjpo

View full text Add to dashboard Cite

ObjectiveTo describe haematocrit at birth in preterm infants who received ≥60 s of delayed cord clamping (DCC).DesignRetrospective observational study.SettingA California public hospital with an American Academy of Pediatrics level 4 neonatal intensive care unit, with 3500–4000 deliveries annually.Participants467 preterm infants born at <35 weeks’ gestational age (GA) between January 2013 and December 2018.Primary and secondary outcome measuresHaematocrit reference ranges for 0–4 hours after birth and paired haematocrit differences between 0–4 and 4–24 hours.MethodsHaematocrits were obtained when clinically indicated and collected from arterial, venous and capillary sources. Haematocrits obtained after packed red blood cell transfusions were excluded. We summarised the first available haematocrit between 0 and 4 hours by GA strata. We used mixed-effects linear regression to describe the associations between haematocrit and predictor variables including GA, male sex and hours after an infant’s birth. We also compared paired haematocrits at 0–4 and 4–24 hours after birth.ResultsThe median GA of the 467 included infants was 33.3 weeks, birth weight was 1910 g and DCC duration was 60 s. The mean (95% CI) first haematocrit at 0–4 hours was 46.6 (45.0% to 48.1%), 51.2 (49.6% to 52.8%), 50.6 (49.1% to 52.1%), 54.3 (52.8% to 55.8%) and 55.6 (54.6% to 56.6%) for infants 23–29, 30–31, 32, 33 and 34 weeks’ GA strata, respectively. The subanalysis of 174 infants with paired haematocrits at 0–4 and 4–24 hours showed that for each additional hour after birth, the mean (95% CI) haematocrit increased by 0.2 (0.1% to 0.3%), 0.2 (0.1% to 0.4%) and 0.1 (0.0% to 0.2%) for infants in 23–29, 30–31 and 32 weeks’ GA strata, respectively. The subanalysis showed no change between the paired haematocrits in the 33 and 34 weeks’ GA strata.ConclusionsOur study describes haematocrit in preterm infants who received ≥60 s DCC as standard of care. Haematocrit during the first 0–4 hours in our study is higher than the previously described reference ranges prior to DCC becoming routine clinical practice. The paired second haematocrit at 4–24 hours is higher than haematocrit at 0–4 hours.

show abstract

“…Specific brain volumes from TEA have been shown to prognosticate motor ability into late childhood. Volumes of the cerebellum and brainstem predicted fine motor skills at age six19 , and volumes of the frontal lobes, basal ganglia, thalamus, cerebellum, and brainstem were correlated with motor scores at age 1118 . Our results corroborate and extend prior studies by showing positive correlation between numerous subcortical volumes at TEA -the volume of the amygdala, brainstem, caudate, cerebellum, hippocampus, lentiform nuclei, subthalami nuclei, and thalamus-and motor outcomes at two-years corrected age.…”

mentioning

confidence: 91%

“…As such, researchers have turned to other structural brain features beyond overt injury. Brain volumes are consistently decreased in extremely-low-birth-weight or preterm cohorts [9][10][11][12][13][14] , and there is evidence that these volumetric changes prognosticate motor ability 13,[15][16][17][18][19][20][21] . Preterm infants also exhibit altered cortical morphometrics, including inner cortical curvature 22,23 , surface area 14,[22][23][24][25][26][27][28] , gyrification 14,23,[28][29][30] , and sulcal depth 14,23,28,29 at term.…”

Section: Introductionmentioning

confidence: 99%

Automated brain morphometric biomarkers from MRI at term predict motor development in very preterm infants

Kline

Illapani

et al. 2020

Preprint

View full text Add to dashboard Cite

Very preterm infants are at high risk for motor impairments. Early intervention can improve outcomes in this cohort, but it would be most effective if clinicians could accurately identify the highest risk infants early. A number of biomarkers for motor development exist, but currently none are sufficiently accurate for early risk-stratification. We prospectively enrolled very preterm (gestational age ≤ 31 weeks) infants from four level-III NICUs. Structural brain MRI was performed at term-equivalent age. We used a well-established pipeline to automatically derive brain volumetrics and cortical morphometrics, cortical surface area, sulcal depth, gyrification index, and inner cortical curvature, from structural MRI. We related these objective measures to Bayley-III motor scores (overall, gross, and fine) at two-years corrected age. Lasso regression identified the three best predictive biomarkers for each motor scale from our initial feature set. In multivariable regression, we assessed the independent value of these brain biomarkers, over-and-above known predictors of motor development, to predict motor scores. 75 very preterm infants had high-quality T2-weighted MRI and completed Bayley-III motor testing. All three motor scores were positively associated with regional cortical surface area and subcortical volumes and negatively associated with cortical curvature throughout the majority of brain regions. In multivariable regression modeling, thalamic volume, curvature of the temporal lobe, and curvature of the insula were significant predictors of overall motor development on the Bayley-III, independent of known predictors. Objective brain morphometric biomarkers at term show promise in predicting motor development in very preterm infants.

show abstract

Visual–motor integration and fine motor skills at 6½ years of age and associations with neonatal brain volumes in children born extremely preterm in Sweden: a population-based cohort study

Cited by 33 publications

References 57 publications

Nurturing the preterm infant brain: leveraging neuroplasticity to improve neurobehavioral outcomes

Nurturing the preterm infant brain: leveraging neuroplasticity to improve neurobehavioral outcomes

Haematocrit in <35 weeks preterm infants who received at least 60 seconds of delayed cord clamping: a retrospective observational study

Automated brain morphometric biomarkers from MRI at term predict motor development in very preterm infants

Contact Info

Product

Resources

About