Association between Postnatal Dexamethasone for Treatment of Bronchopulmonary Dysplasia and Brain Volumes at Adolescence in Infants Born Very Preterm - 19/03/14
, Alice C. Burnett, PhD 2, Katherine J. Lee, PhD 2, 4, 5, Gehan Roberts, PhD 4, 6, Deanne K. Thompson, PhD 2, 7, 8, Stephen J. Wood, PhD 9, Alan Connelly, PhD 8, Peter J. Anderson, PhD 2, 4, Lex W. Doyle, MD 1, 2, 3for the
Victorian Infant Collaborative Study Group∗
Abstract |
Objectives |
To compare brain volumes in adolescents who were born extremely preterm (<28 weeks gestation) who had received postnatal dexamethasone, and to determine if there was a postnatal dexamethasone dose–response effect on brain volumes.
Study design |
Geographical cohort study of extremely preterm adolescents born in 1991-1992 in Victoria, Australia. T1-weighted magnetic resonance imaging was performed at 18 years of age. Segmented and parcellated brain volumes were calculated using an automated segmentation method (FreeSurfer) and compared between groups, with and without adjustment for potential confounders. The relationships between total postnatal dexamethasone dose and brain volumes were explored using linear regression.
Results |
Of the 148 extremely preterm participants, 55 (37%) had received postnatal dexamethasone, with a cumulative mean dose of 7.7 mg/kg. Compared with participants who did not receive postnatal dexamethasone, those who did had smaller total brain tissue volumes (mean difference −3.6%, 95% CI [−7.0%, −0.3%], P value = .04) and smaller white matter, thalami, and basal ganglia volumes (all P < .05). There was a trend of smaller total brain and white matter volumes with increasing dose of postnatal dexamethasone (regression coefficient −7.7 [95% CI −16.2, 0.8] and −3.2 [−6.6, 0.2], respectively).
Conclusions |
Extremely preterm adolescents who received postnatal dexamethasone in the newborn period had smaller total brain tissue volumes than those who did not receive postnatal dexamethasone, particularly white matter, thalami, and basal ganglia. Vulnerability of brain tissues or structures associated with postnatal dexamethasone varies by structure and persists into adolescence.
Le texte complet de cet article est disponible en PDF.Keyword : BPD, MRI, PCS
Plan
| Funded by Australian National Health and Medical Research Council (491246 to L.D., P.A., S.W., J.C.), Centre of Clinical Research Excellence (546519, Senior Research Fellowship 628371 [to P.A.], Early Career Fellowship 1053787 [to J.C.], Early Career Fellowship 1012236 [to D.T.], and Career Development Fellowship 1053609 [to K.L.]), and Victorian Government Operational Infrastructure Support Program. The authors declare no conflicts of interest. |
Vol 164 - N° 4
P. 737 - avril 2014 Retour au numéro
Article précédent
- Oxygen Saturation Targeting in Preterm Infants Receiving Continuous Positive Airway Pressure
- Kathleen Lim, Kevin I. Wheeler, Timothy J. Gale, Hamish D. Jackson, Jonna F. Kihlstrand, Cajsa Sand, Jennifer A. Dawson, Peter A. Dargaville
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