Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 951-960 (doi:10.1542/peds.2006-0553)

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (15) Citing Articles via Google Scholar Google Scholar Articles by Anderson, N. G. Articles by Inder, T. E. Search for Related Content PubMed PubMed Citation Articles by Anderson, N. G. Articles by Inder, T. E. Related Collections Premature & Newborn Social Bookmarking                         What's this?

ARTICLE

Detection of Impaired Growth of the Corpus Callosum in Premature Infants

Nigel G. Anderson, MBChB, FRANZCR^a, Isabelle Laurent, MD^b, Lianne J. Woodward, MA, PhD^c and Terrie E. Inder, MD, PhD^d

^a Department of Radiology, Christchurch Hospital, Christchurch, New Zealand
^b Department of Pediatrics, Hôpital Bon-Secours, Metz, France
^c Canterbury Child Development Research Group, University of Canterbury, Christchurch, New Zealand
^d Departments of Pediatrics, Neurology, and Radiology, St Louis Children's Hospital, Washington University, St Louis, Missouri

OBJECTIVE. There is an urgent need for a bedside method to assess the effectiveness of neonatal therapies designed to improve cerebral development in very low birth-weight infants. The aim of this study was to assess the impact of preterm birth on the serial growth of the corpus callosum and how soon it could be detected after birth with cranial ultrasound.

METHODS. We recruited 61 very low birth-weight infants admitted to a single regional level III NICU from 1998 to 2000. Study infants had 2 cranial sonograms 7 days apart in the first 2 weeks of life and further sonograms at 6 weeks and at term equivalent. At each time point, the length of the corpus callosum and cerebellar vermis was measured on midline sagittal images, with growth rates calculated in millimeters per day. We compared growth of corpus callosum and cerebellar vermis in individuals, between birth age groups, and with corrected gestational age. We used antenatal growth rate of the corpus callosum of 0.2 to 0.27 mm/day as a reference. Relationships between corpus callosum growth rates and neurodevelopmental outcome at 2 years of age (corrected) were also examined.

RESULTS. Growth of the corpus callosum was normal in most infants during the first 2 weeks of life but slowed after this (0.21 mm/day from 0–2 weeks vs 0.11 mm/day for weeks 2–6). Slowing of corpus callosum growth below expected reference range was consistently detectable by age 6 weeks for 96% of infants born between 23 and 33 weeks' gestation. Although some improvement in growth rate was observed for 15% of infants after 6 weeks, this was confined to infants born after 28 weeks. Vermis length correlated strongly with corpus callosum length. By 2 years of age, serious motor delay and cerebral palsy were associated with poorer growth of the length of the corpus callosum between 2 and 6 weeks after birth.

CONCLUSIONS. The effect of preterm birth on growth of the corpus callosum is detectable by 6 weeks after delivery in preterm infants born at gestations of 23 to 33 weeks. Reduced growth of the corpus callosum in weeks 2 to 6, places these infants at elevated risks of later psychomotor delay and cerebral palsy.

---

Key Words: corpus callosum • cerebellum • ultrasonography • brain • growth and development • leucomalacia • periventricular • infant • very low birth weight • developmental disabilities • cerebral palsy

Abbreviations: VLBW—very low birth weight • TE—echo time • FOV—field of view • NEX—number of excitations • MDI—mental development index • PDI—psychomotor development index • IVH—intraventricular hemorrhage • IUGR—intrauterine growth restriction • PVL—periventricular leucomalacia

---

Accepted Apr 13, 2006.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				Z. Nagy, J. Ashburner, J. Andersson, S. Jbabdi, B. Draganski, S. Skare, B. Bohm, A.-C. Smedler, H. Forssberg, and H. Lagercrantz Structural Correlates of Preterm Birth in the Adolescent Brain Pediatrics, November 1, 2009; 124(5): e964 - e972. [Abstract] [Full Text] [PDF]

				J. Maunu, R. Parkkola, H. Rikalainen, L. Lehtonen, L. Haataja, H. Lapinleimu, and and the PIPARI Group Brain and Ventricles in Very Low Birth Weight Infants at Term: A Comparison Among Head Circumference, Ultrasound, and Magnetic Resonance Imaging Pediatrics, February 1, 2009; 123(2): 617 - 626. [Abstract] [Full Text] [PDF]

				S. J. Counsell, A. D. Edwards, A. T. M. Chew, M. Anjari, L. E. Dyet, L. Srinivasan, J. P. Boardman, J. M. Allsop, J. V. Hajnal, M. A. Rutherford, et al. Specific relations between neurodevelopmental abilities and white matter microstructure in children born preterm Brain, December 1, 2008; 131(12): 3201 - 3208. [Abstract] [Full Text] [PDF]

				S. Yoshida, K. Hayakawa, A. Yamamoto, T. Kanda, and Y. Yamori Pontine Hypoplasia in Children with Periventricular Leukomalacia AJNR Am. J. Neuroradiol., March 1, 2008; 29(3): 425 - 430. [Abstract] [Full Text] [PDF]

				M. Allin, C. Nosarti, A. Narberhaus, M. Walshe, S. Frearson, A. Kalpakidou, J. Wyatt, L. Rifkin, and R. Murray Growth of the Corpus Callosum in Adolescents Born Preterm Arch Pediatr Adolesc Med, December 1, 2007; 161(12): 1183 - 1189. [Abstract] [Full Text] [PDF]