Neonatal Critical Illness, 8-Year White Matter Microstructure, and Motor Function In Children Born Very Preterm.

IF 3.9 2区医学 Q1 PEDIATRICS

Journal of Pediatrics Pub Date : 2025-05-22 DOI:10.1016/j.jpeds.2025.114667

Sarvenaz Oloomi, Steven Ufkes, Thiviya Selvanathan, Cecil Chau, Elke Roland, Ting Guo, Vann Chau, Ruth E Grunau, Steven P Miller

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引用次数: 0

Abstract

Objective: To assess relationships between neonatal critical illness in children born preterm with white matter maturation and clinical motor and visual-motor integration performance at 8 years.

Study design: Prospective longitudinal study of 234 neonates (24-32 weeks gestational age [GA]) recruited from 2006-2013 at a tertiary neonatal intensive care unit. Neonatal critical illness included infection, bronchopulmonary dysplasia, retinopathy of prematurity, severe intraventricular hemorrhage, and significant white matter injury. At age 8 years, children completed visual-motor (Beery-Buktenica Developmental Test of Visual-Motor Integration, 6^th ed.) and motor (Movement Assessment Battery for Children, 2^nd ed.) assessments. Tract-based spatial statistics were used to analyze fractional anisotropy (FA) from diffusion tensor imaging (DTI) acquired at 8 years to measure white matter maturation.

Results: Of 226 survivors, 129 children (69 males [53%]) were assessed at 8 years and had high-quality DTI. Neonatal critical illness counts ≥ 3 were associated with 11.8-point decrease in motor (CI -23-(-.55), p=.04) and 11.3-point decrease in visual-motor integration scores (CI -18.2-(-4.5), p=.001), accounting for GA and maternal education. Higher neonatal critical illness counts (p = .04) and lower motor (p < .001) and visual-motor integration (p = .04) scores were related to bilateral reductions in white matter FA in the corpus callosum and motor association pathways, accounting for GA, neonatal brain injury, maternal education, and age at scan.

Conclusions: Cumulative critical illness in neonates born preterm is associated with long-term changes in white matter microstructure and maturation, which are related to motor and visual motor performance at school-age. These findings highlight the long-term importance of neonatal intensive care exposures and need for school-age follow-up of children born preterm.

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新生儿危重症，8岁白质微结构和早产儿运动功能。

目的：探讨脑白质成熟早产儿危重症与8岁时临床运动和视觉运动整合表现的关系。研究设计：对2006-2013年在某三级新生儿重症监护室招募的234名新生儿（24-32周胎龄[GA]）进行前瞻性纵向研究。新生儿危重疾病包括感染、支气管肺发育不良、早产儿视网膜病变、严重脑室内出血和明显的白质损伤。在8岁时，儿童完成了视觉-运动（beerry - buktenica视觉-运动整合发展测试，第6版）和运动（儿童运动评估电池，第2版）评估。利用基于束的空间统计分析8岁时获得的弥散张量成像（DTI）的分数各向异性（FA），以测量白质成熟度。结果：226名幸存者中，129名儿童（69名男性[53%]）在8岁时进行了评估，并获得了高质量的DTI。新生儿危重疾病计数≥3与运动评分下降11.8分（CI -23-(- 0.55), p=.04）和视觉-运动整合评分下降11.3分（CI -18.2-(-4.5), p=.001）相关，考虑到GA和母亲教育程度。较高的新生儿危重疾病计数（p = 0.04）和较低的运动（p < 0.001）和视觉-运动整合（p = 0.04）评分与胼胝体和运动关联通路的双侧白质FA减少有关，考虑到GA、新生儿脑损伤、母亲教育程度和扫描年龄。结论：早产儿积累性危重疾病与脑白质结构和成熟度的长期变化有关，并与学龄期运动和视觉运动表现有关。这些发现强调了新生儿重症监护暴露的长期重要性以及对早产儿童进行学龄随访的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.