Sex Differences in the Association of Pre-Transfusion Hemoglobin Levels with Brain Structure and Function in the Preterm Infant

Amanda Benavides; Edward F Bell; Amy L Conrad; Henry A Feldman; Michael K Georgieff; Cassandra D Josephson; Timothy Koscik; Sean R Stowell; Martha Sola-Visner; Peg Nopoulos

doi:10.1016/j.jpeds.2021.12.051

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Sex Differences in the Association of Pre-Transfusion Hemoglobin Levels with Brain Structure and Function in the Preterm Infant

Journal article

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Sex Differences in the Association of Pre-Transfusion Hemoglobin Levels with Brain Structure and Function in the Preterm Infant

Amanda Benavides, Edward F Bell, Amy L Conrad, Henry A Feldman, Michael K Georgieff, Cassandra D Josephson, Timothy Koscik, Sean R Stowell, Martha Sola-Visner and Peg Nopoulos

The Journal of pediatrics, Vol.243, pp.78-84.e5

12/2021

DOI: 10.1016/j.jpeds.2021.12.051

PMCID: PMC9088851

PMID: 34968498

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https://www.ncbi.nlm.nih.gov/pmc/articles/9088851View

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Abstract

Objective To assess sex-specific differences in early brain structure and function of preterm infants after red blood cell (RBC) transfusions. Study design A single-center subset of infants with a birth weight <1000 g and gestational age 22-29 weeks were enrolled from the National Institute of Child Health and Human Development’s Neonatal Research Network Transfusion of Prematures Trial. Hemoglobin (Hb) concentration obtained directly before each transfusion (pretransfusion Hb [ptHb]) was obtained longitudinally throughout each infant’s neonatal intensive care unit stay and used as a marker of degree of anemia (n = 97). Measures of regional brain volumes using magnetic resonance imaging were obtained at ∼40 weeks postmenstrual age or at hospital discharge, if earlier (n = 29). Measures of brain function were obtained at 12 months corrected age using the Bayley Scales of Infant & Toddler Development, 3rd Edition (n = 34). Results PtHb was positively correlated with neonatal cerebral white matter volume in males (B = +0.283; P = .006), but not females (B = −0.099; P = .713), resulting in a significant sex interaction (P = .010). Bayley-III gross motor scores and a pooled mean score were significantly lower in association with higher ptHb in females (gross motor score: B = −3.758; P = .013; pooled mean score: B = −1.225; P = .030), but not males (gross motor score: B = +1.758; P = .167; pooled mean score: B = +0.621; P = .359). Higher ptHb was associated with descriptively lower performance on multiple Bayley-III subscales in females, but not in males. Conclusions This study demonstrates sex-specific associations between an early marker of anemia and RBC transfusion status (ie, ptHb) with both neonatal white matter volume and early cognitive function at age 12 months in preterm infants.

Details

Title: Subtitle: Sex Differences in the Association of Pre-Transfusion Hemoglobin Levels with Brain Structure and Function in the Preterm Infant
Creators: Amanda Benavides
Edward F Bell
Amy L Conrad
Henry A Feldman
Michael K Georgieff
Cassandra D Josephson
Timothy Koscik
Sean R Stowell
Martha Sola-Visner
Peg Nopoulos
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.243, pp.78-84.e5
DOI: 10.1016/j.jpeds.2021.12.051
PMID: 34968498
PMCID: PMC9088851
NLM abbreviation: J Pediatr
ISSN: 0022-3476
eISSN: 1097-6833
Grant note: DOI: 10.13039/100000025, name: National Institute of Mental Health, award: 5T32MH019113-26; DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute, award: 5779, 5P01HL046925-22
Language: English
Date published: 12/2021
Academic Unit: Neurology; Psychiatry; Pediatric Psychology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Craniofacial Anomalies Research Center; Neonatology
Record Identifier: 9984203942702771

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