Journal article
Long-term outcome of brain structure in female preterm infants: possible associations of liberal versus restrictive red blood cell transfusions
The journal of maternal-fetal & neonatal medicine, Vol.34(20), pp.3292-3299
11/13/2019
DOI: 10.1080/14767058.2019.1683157
PMCID: PMC7269074
PMID: 31722594
Abstract
Preterm infants who receive differential red blood cell (RBC) transfusions at birth may show brain structure differences across development, including abnormalities in white matter (WM) structure and organization. This study investigated long-term outcomes of brain structure in female infants born preterm, at an average age of 13 years old, who received red blood cell (RBC) transfusions in the neonatal period according to a liberal or restrictive approach. Results from this study will increase understanding of the effects of transfusion on the developing brain.
This follow-up study included female preterm infants who participated in a clinical trial and had been randomized at birth to either a liberal or restrictive hematocrit threshold. Brain structures were measured in childhood using structural magnetic resonance imaging (MRI) scans. Due to the low number of females in the restrictive transfusion group at follow-up, additional females were recruited for inclusion. Main outcome measures included cerebral and subcortical brain region volumes.
Total intracranial volume was significantly decreased in females who were randomized to higher average hematocrit levels at birth. Infants in the liberal transfusion group had proportionately smaller volumes in all measures of regional cerebral WM and subcortical brain volumes, reaching significance for temporal lobe WM and caudate volumes.
Female premature infants who received a liberal transfusion threshold at birth had decreased WM volumes, which suggests the potential long-term neurodevelopmental risks associated with liberal transfusion practices.
Details
- Title: Subtitle
- Long-term outcome of brain structure in female preterm infants: possible associations of liberal versus restrictive red blood cell transfusions
- Creators
- Amanda Benavides - Department of Psychiatry, University of Iowa, Iowa City, IA, USAAmy L Conrad - University of Iowa Stead Family Children's Hospital, Iowa City, IA, USAJane E Brumbaugh - Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USAVincent Magnotta - Department of Radiology, University of Iowa, Iowa City, IA, USAEdward F Bell - University of Iowa Stead Family Children's Hospital, Iowa City, IA, USAPeggy Nopoulos - Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- The journal of maternal-fetal & neonatal medicine, Vol.34(20), pp.3292-3299
- DOI
- 10.1080/14767058.2019.1683157
- PMID
- 31722594
- PMCID
- PMC7269074
- NLM abbreviation
- J Matern Fetal Neonatal Med
- ISSN
- 1476-7058
- eISSN
- 1476-4954
- Publisher
- England
- Grant note
- T32 HL007344 / NHLBI NIH HHS T32 MH019113 / NIMH NIH HHS T32 GM007337 / NIGMS NIH HHS
- Language
- English
- Date published
- 11/13/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Psychiatry; Pediatric Psychology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Craniofacial Anomalies Research Center; Neonatology
- Record Identifier
- 9984070235102771
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