Neurological Development in Premature Infants

Perinatal/neonatal brain injury is a leading cause of growth and development impairments of the brain and central nervous system.  To improve long-term quality of life for high-risk newborns and high-risk preterm newborns, investigators at Nationwide Children’s are working to prevent perinatal/neonatal brain injury.

Research efforts focus on ways to detect perinatal/neonatal brain injury early among extremely premature infants, applying advanced MRI as a tool to help predict long-term neurological outcomes and understanding the effects neonatal therapeutic hypothermia has on the brain when an infant has been deprived oxygen. 

Faculty Focused on Neurological Development in Premature Infants

Basic Science/Translational:

• Nehal A. Parikh, DO, MS
• Jill Heathcock, PhD

Clinical/Translational Research:

• Keith Yeates, PhD
• Chris Timan, MD

Latest Neurological Development in Premature Infants Research Findings

Predicting Outcomes for Extremely Preterm Infants throughout an Entire NICU Stay
The goal of this study was to develop outcome predictors for extremely preterm infants using factors available over the course of NICU hospitalization. They found that prediction of death or neurodevelopmental impairment is improved by using information available later during the clinical course.

Access an abstract of this study: Outcome Trajectories in Extremely Preterm Infants. Pediatrics. 2012 Jul;130(1):e115-e125.

Gestational Weight Gain and Child Cognitive Development
The Institute of Medicine (IOM) recently revised gestational weight gain (GWG) guidelines, yet little is known about the association between extremes of GWG and child cognition. This study found that familial factors are important confounders of the association between GWG and cognitive development at 4 and 7 years of age. After controlling for such factors, GWG was generally unassociated with child development.

Access an abstract of this study: Gestational weight gain and child cognitive development. Int J Epidemiol. 2012 Feb 7. [Epub ahead of print]

A Method to Identify Brain Region Volumes on MRI in High-Risk Preterm Newborns
Most extremely preterm newborns show signs of delayed brain growth and/or signaling abnormalities on MRI when at term-equivalent age.  Brain volumes as detected by MRI could serve as biomarkers for evaluating the effects of NICU care and predicting neurodevelopmental outcomes. Here, investigators describe a comprehensive method to help accurately identify brain region volumes on MRI scans of high-risk preterm newborns

Access an abstract of this study:  Comprehensive brain MRI segmentation in high risk preterm newborns. PLoS One. 2010 Nov 8;5(11):e13874.

Current Neurological Development in Premature Infants Grants

Neuroimaging in Infants Born Preterm, The Ohio State University Medical Center (Leif Nelin)

Advanced MRI to Assess Neonatal Care and Outcome, National Institutes of Health – Best Pharmaceuticals for Children Act (Nehal A. Parikh)

Evaluation of Diffusion Tensor Magnetic Resonance Imaging and Other Quantitative MRI Technologies as a Surrogate Measure for Neurosensory Impairments in Extremely Preterm Infants, National Institutes of Health (Nehal A. Parikh)

Of Note

Nationwide Children’s Joins National Study of Therapeutic Hypothermia
The National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health has launched the first large-scale, multi-center study to investigate the effectiveness of body cooling treatment in infants and children who have had cardiac arrest. Nationwide Children’s Hospital is one of 34 centers participating in The Therapeutic Hypothermia after Pediatric Cardiac Arrest (THAPCA) trials across America.

Therapeutic hypothermia, or body cooling, has been successfully used in adults after cardiac arrest and in newborn infants after birth asphyxia, or lack of oxygen, to improve survival and outcomes, but it has not been studied in infants or children who have had cardiac arrest. The goal of the study is to minimize brain injury in infants and children who experience cardiac arrest and ultimately improve survival rates.