Foetal growth restriction is associated with structural changes in the frontal lobe in very low birthweight premature infants.

AIMS: To analyze the development of the frontal cortical and subcortical areas in children with a history of prematurity and very low birthweight, and to evaluate its relationship with foetal growth restriction (FGR) and birthweight.

METHODS

This cohort study was carried out in two stages: retrospectively, considering very low weight newborns born at our hospital between January 2008 and December 2016; and prospectively, performing a structural brain analysis using magnetic resonance imaging and a cognitive performance study using the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V).

RESULTS

The study population consisted of 48 children with an average age of 110.7 months (95 % CI 102.6-118.8) with a history of prematurity and a birthweight of less than 1500g. Of these children, nine had suffered FGR. FGR is associated with a significantly smaller medial orbitofrontal cortex and a significantly larger anterior cingulate cortex. The surface area of the medial orbitofrontal cortex of both hemispheres is significantly associated with the scores obtained in the WISC-V test for verbal comprehension and visual-spatial index.

CONCLUSIONS

FGR and birthweight are both related to structural alterations in the frontal lobe. The surface area of the orbitofrontal cortex is strongly influenced by the weight at birth.