University of Oulu

Kuula, J., Martola, J., Hakkarainen, A., Räikkönen, K., Savolainen, S., Salli, E., Hovi, P., Björkqvist, J., Kajantie, E., & Lundbom, N. (2022). Brain volumes and abnormalities in adults born preterm at very low birth weight. The Journal of Pediatrics, 246, 48-55.e7.

Brain volumes and abnormalities in adults born preterm at very low birth weight

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Author: Kuula, Juho1,2; Martola, Juha1; Hakkarainen, Antti1;
Organizations: 1HUS Medical Imaging Center, Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
2Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
3Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
4Department of Physics, University of Helsinki, Helsinki, Finland
5PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
6Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
7Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Elsevier, 2022
Publish Date: 2022-09-21


Objectives: To assess radiographic brain abnormalities and investigate volumetric differences in adults born preterm at very low birth weight (<1500 g), using siblings as controls.

Study design: We recruited 79 adult same-sex sibling pairs with one born preterm at very low birth weight and the sibling at term. We acquired 3-T brain magnetic resonance imaging from 78 preterm participants and 72 siblings. A neuroradiologist, masked to participants’ prematurity status, reviewed the images for parenchymal and structural abnormalities, and FreeSurfer software 6.0 was used to conduct volumetric analyses. Data were analyzed by linear mixed models.

Results: We found more structural abnormalities in very low birth weight participants than in siblings (37% vs 13%). The most common finding was periventricular leukomalacia, present in 15% of very low birth weight participants and in 3% of siblings. The very low birth weight group had smaller absolute brain volumes (−0.4 SD) and, after adjusting for estimated intracranial volume, less gray matter (−0.2 SD), larger ventricles (1.5 SD), smaller thalami (−0.6 SD), caudate nuclei (−0.4 SD), right hippocampus (−0.4 SD), and left pallidum (−0.3 SD). We saw no volume differences in total white matter (−0.04 SD; 95% CI, −0.13 to 0.09).

Conclusions: Preterm very low birth weight adults had a higher prevalence of brain abnormalities than their term-born siblings. They also had smaller absolute brain volumes, less gray but not white matter, and smaller volumes in several gray matter structures.

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Series: Journal of pediatrics
ISSN: 0022-3476
ISSN-E: 1097-6833
ISSN-L: 0022-3476
Volume: 246
Pages: 48 - 55.e7
DOI: 10.1016/j.jpeds.2022.03.009
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: Funded by the Doctoral Programme in Clinical Research, University of Helsinki; Academy of Finland (Grants 274794 and 315680 to Eero Kajantie); the European Commission (Horizon2020 award 733280 RECAP Research on Children and Adults Born Preterm); the Finnish Foundation for Pediatric Research; Finska Läkaresällskapet; the Juho Vainio Foundation; the Paulo Foundation; the Päivikki and Sakari Sohlberg Foundation; the Jalmari and Rauha Ahokas Foundation; the Novo Nordisk Foundation; the Signe and Ane Gyllenberg Foundation; the Sigrid Jusélius Foundation; and the Yrjö Jahnsson Foundation. The authors declare no conflicts of interest.
Copyright information: 2022 The Author(s). This is an open access article under the CC BY license (