Neonatal-Perinatal Medicine Fellow McMaster Children's Hospital Hamilton, Ontario, Canada
Background: Preterm infants are susceptible to white matter injury and altered brain growth. Late preterm neonates have been reported to have smaller brain volumes compared to full-term infants at term equivalent age (TEA). Importantly, smaller brain size of preterm neonates was found to be associated with poor neurodevelopment outcomes at 2 years. Multiple factors are known to impact brain growth such as systemic inflammation, fetal growth restriction and postnatal steroid exposure Objective: We aim to (i) compare linear brain metrics at TEA between neonates born ≤28 weeks gestational age (GA) and 28-32 weeks GA; (ii) study association between cumulative postnatal corticosteroid exposure on brain metrics in preterm neonates ≤32 weeks GA Design/Methods: A retrospective chart review of all consecutive infants born at GA≤ 32 weeks between Jan2019-Dec2022. We exclude infants with major brain injury [Grade 3-4 intraventricular hemorrhage, periventricular leukomalacia, post-hemorrhagic ventricular dilatation]. Glucocorticoid exposure between birth to TEA is quantified in mean prednisone-equivalent dose. The cUS performed at TEA is assessed at midcoronal, parasagittal, and midsagittal planes. Regional brain metrics are quantified under the following categories: (i) Cerebrum [Biparietal diameter and depth of cingulate sulcus]; (ii) Cerebral White Matter [Corpus callosum length, thickness, and fastigial distance]; (iii) Deep Grey Matter [Basal ganglia and Caudate Nucleus]; (iv) Cerebellum [height, width, transverse diameter]. Work so far: Institutional Ethics Approval obtained. 1113 preterm neonates have been found eligible for the study. Clinical and imaging data is being collected [completed 30]. Standard descriptive and analytic statistics will be used to summarize the results. Multivariate regression will be used for steroid exposure and US metrics adjusting for gestational age and sex. Study timeline: Data collection (October 2023 - January 2024), Analysis (February 2024), Result and discussion (March-April 2024)
