Cerebral magnetic resonance imaging findings in children born extremely preterm, very preterm, and at term.

BACKGROUND: The aim of this study was to compare findings on cerebral MRI scans of infants born extremely preterm (i.e., gestation < 28 weeks, very preterm; gestation 28-31 weeks) and at term. METHODS: MRI scans obtained in a cohort of 29 extremely preterm children at 11 years, 51 very preterm young adults at 19 years, and respective term-born controls were scored according to presence and degree of MRI pathology. RESULTS: MRI pathology was found in 76% of the extremely preterm children vs 31% of their controls (odds ratio 4.3; 95% confidence interval, 1.5-137.5) and in 55% of the very preterm group vs 19% of their controls (odds ratio 5.2; 95% confidence interval, 2.5-10.9). The distribution of moderate and severe pathology did not differ among the groups. CONCLUSIONS: The extremely preterm, very preterm, and term subjects shared the same morphological pathology, revealing no specific preterm MRI pattern, but both premature cohorts had higher frequencies. Differences were mainly limited to mild pathology. Whether MRI lesions were more common in the extremely preterm than in the very preterm group is uncertain as the difference in frequency was similar in the two control groups, suggesting a lack of objective criteria for differentiating mild pathology from normality or that MRI scans normally differ at 11 and 19 years of age.

Low birth weight young adults: quality of life, academic achievements and social functioning.

AIM: To compare the quality of life (QOL), academic achievements and social functioning of 134 non-handicapped low birth weight (LBW, birth weight < 2000 g) and 135 normal birth weight (NBW, birth weight > 3000 g) young adults. STUDY DESIGN: Population-based longitudinal follow-up study. METHODS: The Norwegian version of the originally US child health questionnaire, child form 87 (CHQ-CF87), a generic health instrument was applied to measure different physical and psychosocial concepts of QOL. Questionnaires and semi-structured interviews were applied to the cohort to register different aspects of social functioning and academic performance. RESULTS: The LBW group reported well-being in the different aspects of QOL. The LBW group was socially well functioning. The college attendance was similar in the two groups, but more LBW young adults had dropped out of school or attended individually adjusted classes. Performance in mathematics for the LBW women attending academic college was lower. With this exception, the academic performance was comparable in the two groups. CONCLUSION: Except a somewhat higher rate of school dropouts, the overall outcome of school performance, QOL and social functioning in the LBW young adults was comparable to that of the NBW control group.

Cerebral MRI and cognition in nonhandicapped, low birth weight adults.

This study sought to compare cognitive and cerebral findings of magnetic resonance imaging in young adults with low birth weights and in a control group. One hundred thirteen of 173 (65%) eligible adults with birth weights <2000 g, and 100 of 170 (59%) controls, all without major disabilities, were examined at age 19 years. Cerebral 3.0 T magnetic resonance imaging was performed according to standardized protocols. Prorated intelligence quotient was estimated from two subtests of the Wechsler Abbreviated Scale of Ability, a word comprehension test, and matrices. Prominent lateral ventricles and loss of white matter, and thinning of the corpus callosum, were more common in the low birth weight group than in the control group (40% vs. 15%, respectively; odds ratio, 3.8; P < 0.001; and 31% vs. 7%, respectively; odds ratio, 6.0; P < 0.001). Low birth weight adults exhibited lower mean intelligence quotients (95 vs. 101, respectively; P < 0.001). Low birth weight adults face an increased risk of prominent ventricles, global loss of white matter, and thinning of the corpus callosum. Similar magnetic resonance imaging findings are not uncommon among healthy adults.

Growth and somatic health until adulthood of low birthweight children.

OBJECTIVE: To compare trajectories for growth and somatic health characteristics until adulthood of non-handicapped low birthweight (LBW) and normal birthweight (NBW) children. STUDY DESIGN: Population-based longitudinal follow-up study. PATIENTS: LBW (<2 kg) and NBW (>3 kg) children were followed at 5, 11 and 19 years of age. At 19 years 134 of 173 subjects with LBW (77%), and 135 of the 170 with NBW (79%) participated. RESULTS: Current health and body mass index (BMI) were similar for the groups. The LBW adults were shorter (5.9 cm), had higher systolic (4.5 mm Hg) and diastolic (2.0 mm Hg) blood pressures (BPs), higher heart rates (3.7 beats per min), lower forced expiratory flow at 50% of forced vital capacity (8.5%) and forced expiratory volume in 1 second/forced vital capacity ratios (0.03). All p values are <0.01 for the differences of means given above. Differences in height were mostly due to differences in parental height. From childhood, percentiles for height and systolic BP were maintained for both groups while diastolic BP increased more for the LBW children. The LBW young adults caught up in body proportions. CONCLUSION: Difference in height and systolic BP between the LBW and NBW children tend to be maintained from childhood until young adulthood. The LBW young adults experience catch-up growth in body proportions. The LBW young adults have lower pulmonary function.

Assessing ventricular size: is subjective evaluation accurate enough? New MRI-based normative standards for 19-year-olds.

INTRODUCTION: To create new standards for radiological indices of dilated ventricles and to compare these with subjectively assessed ventricular size. METHODS: One hundred healthy controls (54 females), birth weight above 3,000 g, were followed throughout childhood as part of a longitudinal study of ex-prematures. All had a 3 Tesla brain magnetic resonance scan at age 17-20, and the following measurements were performed: biparietal and occipitofrontal diameters, width and depth of the frontal and occipital horns, diameter of the third ventricle and the frontal sub-arachnoid space. Ventricular size was judged subjectively by two neuroradiologists as being normal, or mildly, moderately or severely dilated. RESULTS: Head circumference was 31 mm higher for males than for females (95% confidence interval (CI) 25-28, p < 0.001). Similar, ventricular size except for the depth of the right frontal horn was larger for male; however, the observed differences were partly accounted for by the larger head circumference. Normative sex specific standards for different cerebral measurements were presented as mean and ranges and additional 2.5, 10, 50, 90, 97.5 percentiles. The mean depth of the left ventricle was larger than the right for males, with an observed difference of 0.6 mm in male (95% CI 0.2-0.9, p = 0.005). The mean width of the left ventricle was larger than the right for females, with an observed difference of 0.4 mm in male (95% CI 0.1-0.7, p = 0.018). Two subjects were judged to have moderately and 36 to have mildly dilated ventricles by observer one, while figures for observer two were one and 14. Overall, the two observers agreed on 15 having either mild or moderate dilatation (kappa 0.43). For both sexes, the mean depth of the frontal horns as well as of the larger occipital horns differed significantly between the no dilatation and the mild/moderate dilatation groups. CONCLUSION: In our unselected cohort of healthy 19-year-olds, a high total of 14% was diagnosed to have dilated cerebral ventricles when subjectively assessed by an experienced neuroradiologist, underscoring the need for our new normative standards.