ICNC Abstracts, ICNC 2018

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Head growth, brain growth and neurodevelopmental outcomes in preterm neonates
Thiviya Selvanathan, Vann Chau, Rollin Brant, Anne Synnes, Ruth Grunau, Steven Miller

Last modified: 2018-09-09

Abstract


OBJECTIVES: (1) To determine the association of small HC at birth with neurodevelopmental outcomes in neonates born at 24-32 weeks gestation; (2) To compare HC growth and Total Cerebral Volume (TCV) growth as predictors of outcomes.

METHODS: 150 preterm neonates were studied prospectively with HC measurements from birth and MRIs early in life and at term equivalent age. TCV was calculated using a semi-automated method. HC and TCV growth rates were calculated as percentage change per week. Outcomes were assessed at 3 years using Bayley III motor and cognitive scores. Multiple linear regressions were used to assess the association of HC & TCV with neurodevelopmental outcomes, accounting for gestational age at birth, brain injury, maternal education and postnatal illness.

RESULTS: 150 neonates had small HC at birth (<10th percentile), which predicted poorer motor (-7 points, p=0.020) and cognitive (-10 points, p<0.001) outcomes. Neonates whose small HC persisted to term had dramatically lower motor (-19 points, p=0.002) and cognitive scores (-16 points, p=0.005); neonates with small HC at birth that normalized by term had improved motor but not cognitive outcomes (-9 points, p=0.001). HC growth rate was only weakly correlated with TCV growth rate (r=0.54, p<0.001). TCV growth rate but not HC growth rate predicted motor outcomes (B=124.8, p=0.023). Neither HC nor TCV predicted cognitive outcomes (p>0.05).

CONCLUSIONS: The relationship between small HC at birth and adverse motor outcomes may be attenuated with normalization of head size and optimal brain growth in the early postnatal period.

Keywords


preterm neonates; neurodevelopmental outcomes; head circumference; brain volumes

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