Abstract
The hippocampus is known to be vulnerable to hypoxia, stress, and undernutrition, all likely to be present in fetal intrauterine growth restriction (IUGR). The effect of IUGR in preterm infants on the hippocampus was studied using 3D magnetic resonance imaging at term-equivalent age Thirteen preterm infants born with IUGR after placental insufficiency were compared with 13 infants with normal intrauterine growth age matched for gestational age. The hippocampal structural differences were defined using voxel-based morphometry and manual segmentation. The specific neurobehavioral function was evaluated by the Assessment of Preterm Infants' Behavior at term and at 24 mo of corrected age by a Bayley Scales of Infant and Toddler Development. Voxel-based morphometry detected significant gray matter volume differences in the hippocampus between the two groups. This finding was confirmed by manual segmentation of the hippocampus with a reduction of hippocampal volume after IUGR. The hippocampal volume reduction was further associated with functional behavioral differences at term-equivalent age in all six subdomains of the Assessment of Preterm Infants' Behavior but not at 24 mo of corrected age. We conclude that hippocampal development in IUGR is altered and might result from a combination of maternal corticosteroid hormone exposure, hypoxemia, and micronutrient deficiency.
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Abbreviations
- APIB:
-
assess of preterm infants' behavior
- FOV:
-
field of view
- FWHM:
-
full width at half maximum
- IUGR:
-
intrauterine growth restriction
- MRI:
-
magnetic resonance imaging
- NEC:
-
necrotizing enterocolitis
- RDS:
-
respiratory distress syndrome
- RI:
-
resistance index
- S/D:
-
systolic/diastolic velocities
- TE:
-
echo time
- TR:
-
repetition time
- VBM:
-
voxel-based morphometry
- WISC:
-
Wechsler Intelligence Scale for Children (WISC)
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Acknowledgements
We thank F. Henri and D. Joliat for technical assistance. We the thank families and infants of the cohort for their participation in this study.
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Supported by the Swiss National Science Foundation, grants No 32-56927.99; 32-102127 (PSH) and in part by NIH grant P41 RR13218, by a research grant from the Whitaker Foundation (SKW), by a research grant from CIMIT (SKW) and by NIH grants R03 CA126466 (SKW) and R01 RR021885 (SKW).
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Lodygensky, G., Seghier, M., Warfield, S. et al. Intrauterine Growth Restriction Affects the Preterm Infant's Hippocampus. Pediatr Res 63, 438–443 (2008). https://doi.org/10.1203/PDR.0b013e318165c005
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DOI: https://doi.org/10.1203/PDR.0b013e318165c005
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