Brain injury in infancy tied to motor, behavioural problems in childhood

03 Jul 2021
The child’s parents claimed MRI results had revealed their son suffering from brain damage because of the treatment.The child’s parents claimed MRI results had revealed their son suffering from brain damage because of the treatment.

Neonatal brain injuries may have short-term impact on infant neurodevelopment, particularly in terms of motor skills and behaviour during childhood, a recent study has found. Using magnetic resonance imaging (MRI), along with a standardized scoring system, may be an effective measure to monitor for such injuries.

The study included 112 neonates born very preterm (<32 weeks of gestation), in whom brain injury was assessed through a neonatal MRI and graded using the Kidokoro Score. Participants were followed-up at 2 years of age (corrected for prematurity) and at 10 years (uncorrected), during which standardized cognitive and motor function tests were administered.

According to the Global Brain Abnormality Score (GBAS), half of the participants had some form of brain abnormality: 34 percent had GBAS scores 4–7, indicative of mild abnormality, while 16 percent scored 8–11 or ≥12, suggesting moderate-to-severe abnormalities.

At 2 years of corrected age, 99 children were available for follow-up, 84 of whom had at least one cognitive, motor, and/or behavioural assessment available for analysis. The researchers found that GBAS and white matter abnormalities significantly correlated with worse cognitive, motor composite, and behavioural outcomes. Adjusting for confounders, including maternal education, did not meaningfully alter these findings.

These interactions persisted until the 10-year follow-up, during which the researchers found that brain injury at term-equivalent age impaired neurodevelopment. GBAS, for example, was correlated with lower full scale IQ scores and poor motor outcomes, as were cerebellar and deep grey matter abnormalities. Deep grey matter abnormalities were likewise linked to internalizing behaviours.

However, after controlling for confounders, most of these correlations were attenuated, leaving only a significant association between GBAS and white matter abnormality with behavioural problems.

J Pediatr 2021;234:46-53.e2