Association of Gestational Age at Birth With Brain Morphometry
Association of Gestational Age at Birth With Brain Morphometry
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DOI：
10.1001/jamapediatrics.2020.2991
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发表时间：
2020-09-21
期刊：
影响因子：
26.1
通讯作者：
Tiemeier, Henning
中科院分区：
文献类型：
--
作者：
El Marroun, Hanan;Zou, Runyu;Tiemeier, Henning
早产和过期分娩与不良的神经精神结局相关。然而，目前尚不清楚在37至42周的足月分娩范围内胎龄的变化是否与神经发育有关。目的探讨10岁儿童出生胎龄与脑结构形态测量的关系。设计、设置和参与者这项基于人群的队列研究包括居住在荷兰鹿特丹的孕妇，预产期在2002年4月1日至2006年1月31日之间。该研究评估了3079名GAB范围为26.3至43.3周的单胎儿童，并在10岁时进行了结构神经影像学检查，这些儿童来自R世代研究，这是一项在鹿特丹进行的纵向、基于人群的前瞻性出生队列研究。数据分析于2019年3月1日至2020年2月28日进行，并在根据审查者建议进行修订时进行。在专门的研究中心，根据冠臀长度（= 12周5天）的超声评估计算GAB。主要结果和测量脑结构，包括全球和区域的脑容量和基于表面的皮质测量（厚度，表面积和脑回），通过磁共振成像进行量化。结果在3079名10岁儿童（1546名[50.2%]女性）中，GAB与整体和局部脑容量呈线性相关。妊娠期越长，脑体积越大;例如，妊娠期每长1周，总脑体积就增加4.5 cm 3/wk（95% CI，2.7-6.3 cm 3/wk）。当样本仅限于足月出生的儿童时，这些相关性持续存在（37-42周的GAB：4.8 cm（3）/周; 95% CI，1.8-7.7 cm（3）/周）。没有观察到GA与脑形态测量学之间存在非线性关联的证据。结论和相关性在这项队列研究中，妊娠时间与儿童期的脑形态测量呈线性相关，包括足月分娩的窗口期。这些发现可能具有显著的临床意义，特别是考虑到择期剖宫产的流行率。本队列研究调查了出生时胎龄与10岁儿童脑结构形态测量的相关性。问题：出生时胎龄与儿童脑结构形态测量是否存在相关性？结果在这项以人群为基础的队列研究中，3079名单胎儿童，妊娠期与出生后10年的全球和区域脑容量，这些线性相关性持续存在时，样本仅限于足月出生的孩子。与妊娠晚期脑容量的快速扩张相一致，出生时的胎龄与更多的脑回化和皮质表面积相关。孕激素持续时间可能对长期神经发育很重要，应该被认为是整个怀孕期间发育的连续体。
Importance Preterm and postterm births are associated with adverse neuropsychiatric outcomes. However, it remains unclear whether variation of gestational age within the 37- to 42-week range of term deliveries is associated with neurodevelopment. Objective To investigate the association of gestational age at birth (GAB) with structural brain morphometry in children aged 10 years. Design, Setting, and Participants This population-based cohort study included pregnant women living in Rotterdam, the Netherlands, with an expected delivery date between April 1, 2002, and January 31, 2006. The study evaluated 3079 singleton children with GAB ranging from 26.3 to 43.3 weeks and structural neuroimaging at 10 years of age from the Generation R Study, a longitudinal, population-based prospective birth cohort from early pregnancy onward in Rotterdam. Data analysis was performed from March 1, 2019, to February 28, 2020, and at the time of the revision based on reviewer suggestions. Exposures The GAB was calculated based on ultrasonographic assessment of crown-rump length (= 12 weeks 5 days) in dedicated research centers. Main Outcomes and Measures Brain structure, including global and regional brain volumes and surface-based cortical measures (thickness, surface area, and gyrification), was quantified by magnetic resonance imaging. Results In the 3079 children (1546 [50.2%] female) evaluated at 10 years of age, GAB was linearly associated with global and regional brain volumes. Longer gestational duration was associated with larger brain volumes; for example, every 1-week-longer gestational duration corresponded to an additional 4.5 cm(3)/wk (95% CI, 2.7-6.3 cm(3)/wk) larger total brain volume. These associations persisted when the sample was restricted to children born at term (GAB of 37-42 weeks: 4.8 cm(3)/wk; 95% CI, 1.8-7.7 cm(3)/wk). No evidence of nonlinear associations between GA and brain morphometry was observed. Conclusions and Relevance In this cohort study, gestational duration was linearly associated with brain morphometry during childhood, including within the window of term delivery. These findings may have marked clinical importance, particularly given the prevalence of elective cesarean deliveries.This cohort study investigates the association of gestational age at birth with structural brain morphometry in children aged 10 years.Question Is there an association of gestational age at birth with structural brain morphometry in childhood? Findings In this population-based cohort study of 3079 singleton children, gestational duration was associated with global and regional brain volumes 10 years after birth and these linear associations persisted when the sample was restricted to term-born children. Consistent with the rapid expansion of brain volume during the third trimester, gestational age at birth was associated with more gyrification and cortical surface area. Meaning Gestational duration may be important for long-term neurodevelopment and should be considered a continuum of development throughout pregnancy.