Infants born 32 to 36 weeks into gestation might have smaller brains and other brain abnormalities, which could result in long-term developmental problems, according to a recent study published online in the journal Radiology.

Dr. Jennifer M. Walsh, the study's lead author, and her fellow researchers at the Royal Women's Hospital in Melbourne, Australia had 199 moderate and late preterm (MLPT) infants and 50 term-born infants undergo MR exams between 38 and 44 weeks of gestation. They assessed the infants for signs of brain injury and compared the size and maturation of various brain structures in both groups.

They found that injury rates were consistent among both groups, but MLPT birth was connected with smaller brain sizes at term-equivalent age. Additionally, the infants' myelination — the formation of a fatty insulating sheath around some nerve fibers — wasn't as developed in one part of the brain and they also had more immature gyral folding — folding of the cerebral cortex to increase the brain's surface area — than the term-born infants.
Most studies focus on very preterm babies — those born less than 30 weeks of pregnancy — because of the potential problems with their development later on, Walsh wrote to DOTmed News.

MLPT babies make up about 80 percent of all preterm births and are largely responsible for the rise in the preterm birth rates over the past 20 years. To date, there have not been any large-scale studies published on brain alterations associated with MLPT birth that could explain the relationships between the infants' brains and behavior.

It was only in recent years that studies have revealed that MLPT babies can potentially also have similar problems, but to a lesser extent. "This is likely the reason why there have not been large-scale studies published on brain alterations in this group of babies using MRI," Walsh wrote. "Moreover, such studies are very time consuming and expensive, which means that not anyone can do them."

For Walsh's study, there is still more work to be done. "We do not know the importance of these findings at this stage as we have not related the brain MRI findings to the way the brain functions in early childhood," wrote Walsh.

The children in the study are currently being evaluated at two years old and the researchers will have the results in about a year. It will help them to understand if any of the differences in the babies' brains have any or no long-term ill-effects on brain function, wrote Walsh.

The researchers are hoping to learn more about the impact that MLPT birth has on the brain so they can start to try different treatments on the infants that are designed to improve brain function and long-term outcomes.

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