Objective: To assess associations between neonatal brain injury assessed by magnetic resonance imaging and cognitive, motor, and behavioral outcomes at two and ten years of age, in a longitudinal cohort of children born very preterm.
Study design: 112 children born at <32 weeks of gestation participated in a longitudinal prospective study on brain injury and neurodevelopmental outcome. Using the Kidokoro scoring, neonatal brain injury and altered brain growth in white matter, cortical and deep gray matter and cerebellum were assessed. Cognitive, motor, and behavioral outcomes were assessed during follow-up visits at both two (corrected) and ten years of age.
Results: After adjusting for perinatal factors and level of maternal education, the global brain abnormality score was associated with cognition (B=-1.306, p=.005), motor skills (B=-3.176, p<.001) and behavior (B=.666, p=.005) at two years of age, but was not associated with cognition at ten years of age. In the subgroup of children with a moderate-severe global brain abnormality score, MRI was independently associated with cognitive impairment at ten years of age. For children with milder forms of brain injury, only birth weight and level of maternal education were associated with cognitive outcomes.
Conclusion: Neonatal brain injury, assessed by a standardized scoring system, was associated with short-term neurodevelopmental outcome, but only with motor skills and behavior in childhood. Environmental factors, such as level of maternal education, become more important for cognitive development as children grow older, especially for children with relatively mild neonatal brain injury.