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Sex differences in outcome and associations with neonatal brain morphology in extremely preterm children

Sex differences in outcome and associations with neonatal brain morphology in extremely preterm children
Sex differences in outcome and associations with neonatal brain morphology in extremely preterm children
Objective

To investigate sex differences in neurologic and developmental outcomes in extremely preterm (EPT) children and explore associations with neonatal brain morphology.

Study design

A population-based cohort of infants born at <27 weeks gestation underwent magnetic resonance imaging (MRI) at term equivalent age (n = 107). Voxel-based morphometry (n = 27) and tract-based spatial statistics (n = 29) were performed in infants with normal MRI findings. Neurologic and developmental assessment (using the Bayley Scales of Infant and Toddler Development–Third Edition [BSITD-III]) was performed at 30 months corrected age (n = 91).

Results

EPT boys had lower mean cognitive composite scores (P = .03) and lower mean language composite scores (P = .04) compared with EPT girls. Rates of cerebral palsy were similar in the 2 sexes. No perinatal factor explained the variance in outcomes. Visual inspection of T1- and T2-weighted MRI images found that delayed myelination was found more frequently in boys, whereas cerebellar abnormalities were more common in girls. In the subgroup of children with normal MRI findings (n = 27), boys had poorer cognitive function (P = .015) and language function (P = .008), despite larger volumes of cerebellar tissue (P = .029). In boys, cerebellar volume was positively correlated with BSITD-III cognitive and motor scores (P = .04 for both). In girls, white matter volume (P = .02) and cortical gray matter volume (P = .03) were positively correlated with BSITD-III language score. At the regional level, significant correlations with outcomes were found only in girls.

Conclusion

Cognitive and language outcomes at age 30 months were poorer in boys. Sex-related differences were observed on neonatal structural MRI, including differences in the patterns of correlations between brain volumes and developmental scores at both global and regional levels.
BSITD-III, bayley scales of infant and toddler development–third edition, CP, cerebral palsy, CPAP, continuous positive airway pressure, DTI, diffusion tensor imaging, EPT, extremely preterm, EXPRESS, extremely preterm infants in sweden study, MRI, magnetic resonance imaging, TBSS, tract-based spatial statistics
0022-3476
1012-1018
Skiöld, Béatrice
e0462ec7-9993-47b5-92bb-3db4edf06d2d
Alexandrou, Georgios
318999cf-fff1-4bd1-89a8-c214a41c5ce3
Padilla, Nelly
795c7d8a-e73a-4949-887e-75f966d9aed6
Blennow, Mats
14d9f9ca-4587-4372-b964-463355551e31
Ådén, Ulrika
4d84a0ab-ef6d-4cdc-9653-913f1c4f79f3
Skiöld, Béatrice
e0462ec7-9993-47b5-92bb-3db4edf06d2d
Alexandrou, Georgios
318999cf-fff1-4bd1-89a8-c214a41c5ce3
Padilla, Nelly
795c7d8a-e73a-4949-887e-75f966d9aed6
Blennow, Mats
14d9f9ca-4587-4372-b964-463355551e31
Ådén, Ulrika
4d84a0ab-ef6d-4cdc-9653-913f1c4f79f3

Skiöld, Béatrice, Alexandrou, Georgios, Padilla, Nelly, Blennow, Mats and Ådén, Ulrika (2014) Sex differences in outcome and associations with neonatal brain morphology in extremely preterm children. Journal of Pediatrics, 164 (5), 1012-1018. (doi:10.1016/j.jpeds.2013.12.051). (PMID:24530122)

Record type: Article

Abstract

Objective

To investigate sex differences in neurologic and developmental outcomes in extremely preterm (EPT) children and explore associations with neonatal brain morphology.

Study design

A population-based cohort of infants born at <27 weeks gestation underwent magnetic resonance imaging (MRI) at term equivalent age (n = 107). Voxel-based morphometry (n = 27) and tract-based spatial statistics (n = 29) were performed in infants with normal MRI findings. Neurologic and developmental assessment (using the Bayley Scales of Infant and Toddler Development–Third Edition [BSITD-III]) was performed at 30 months corrected age (n = 91).

Results

EPT boys had lower mean cognitive composite scores (P = .03) and lower mean language composite scores (P = .04) compared with EPT girls. Rates of cerebral palsy were similar in the 2 sexes. No perinatal factor explained the variance in outcomes. Visual inspection of T1- and T2-weighted MRI images found that delayed myelination was found more frequently in boys, whereas cerebellar abnormalities were more common in girls. In the subgroup of children with normal MRI findings (n = 27), boys had poorer cognitive function (P = .015) and language function (P = .008), despite larger volumes of cerebellar tissue (P = .029). In boys, cerebellar volume was positively correlated with BSITD-III cognitive and motor scores (P = .04 for both). In girls, white matter volume (P = .02) and cortical gray matter volume (P = .03) were positively correlated with BSITD-III language score. At the regional level, significant correlations with outcomes were found only in girls.

Conclusion

Cognitive and language outcomes at age 30 months were poorer in boys. Sex-related differences were observed on neonatal structural MRI, including differences in the patterns of correlations between brain volumes and developmental scores at both global and regional levels.

Full text not available from this repository.

More information

Published date: May 2014
Keywords: BSITD-III, bayley scales of infant and toddler development–third edition, CP, cerebral palsy, CPAP, continuous positive airway pressure, DTI, diffusion tensor imaging, EPT, extremely preterm, EXPRESS, extremely preterm infants in sweden study, MRI, magnetic resonance imaging, TBSS, tract-based spatial statistics
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 372875
URI: https://eprints.soton.ac.uk/id/eprint/372875
ISSN: 0022-3476
PURE UUID: 50366f13-4834-4721-bc3f-0af9734aea40

Catalogue record

Date deposited: 24 Dec 2014 14:10
Last modified: 21 Aug 2017 16:32

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