Published online January 26, 2009
PEDIATRICS Vol. 123 No. 2 February 2009, pp. 503-511 (doi:10.1542/peds.2008-0025)

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ARTICLE

Longitudinal Brain Volume Changes in Preterm and Term Control Subjects During Late Childhood and Adolescence

Laura R. Ment, MD^a,b, Shelli Kesler, PhD^c, Betty Vohr, MD^d, Karol H. Katz, MS^a, Heidi Baumgartner, BA^c, Karen C. Schneider, MPH^a, Susan Delancy, MA^a, John Silbereis, BA^a, Charles C. Duncan, MD^a,e, R. Todd Constable, PhD^f, Robert W. Makuch, PhD^g and Allan L. Reiss, MD^c

^a Departments of Pediatrics
^b Neurology
^e Neurosurgery
^f Diagnostic Imaging
^g Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut
^c Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, California
^d Department of Pediatrics, Brown Medical School, Providence, Rhode Island

OBJECTIVE. Although preterm very low birth weight infants have a high prevalence of neuroanatomical abnormalities when evaluated at term-equivalent age, patterns of brain growth in prematurely born infants during school age and adolescence remain largely unknown. Our goal was to test the hypothesis that preterm birth results in long-term dynamic changes in the developing brain.

METHODS. We performed serial volumetric MRI studies at ages 8 and 12 years in 55 preterm infants born weighing 600 to 1250 g and 20 term control children who participated in the follow-up component of a prospective, randomized, placebo-controlled intraventricular hemorrhage prevention study.

RESULTS. Total brain volumes increased 2% to 3% between the ages of 8 and 12 years for both preterm and term children. These changes involved reductions in cerebral gray matter while white matter increased. Between 8 and 12 years of age, preterm subjects experienced a 2% decrease in left cerebral gray matter compared with a 10% reduction in left cerebral gray for term controls. For right cerebral gray matter, preterm children experienced a 3% decrease in volume between years 8 and 12, compared with 9% for term controls (group-by-time). In contrast, preterm subjects had a 10% increase in cerebral white matter volumes bilaterally between ages 8 and 12 years, compared with >26% increases for both hemispheres for term controls. Significant differences in regional volume changes between study groups were found in bilateral temporal gray and in parietal white matter.

CONCLUSIONS. Preterm birth continues to perturb the trajectory of cerebral development during late childhood and early adolescence with preterm children, showing both lower gray matter reduction and less white matter gain over time compared with term control subjects.

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Key Words: preterm • brain volume changes • childhood • adolescence • birth weight • gender

Abbreviations: VLBW—very low birth weight • IVH—intraventricular hemorrhage • PVL—periventricular leukomalacia • BPD—bronchopulmonary dysplasia • TBV—total brain volume

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Accepted May 1, 2008.

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