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Altered maturation in brainstem neural conduction in very premature babies with fetal growth restriction

Pediatric Research (2023)Cite this article

Abstract

Background

Using maximum length sequence brainstem auditory evoked response (MLS BAER) to study brainstem neural conduction and maturation in fetal growth restriction (FGR) babies born very prematurely and assess the effect of FGR on brainstem neural maturation.

Methods

MLS BAER was recorded and analyzed at a mean 40 week postmenstrual age in babies born at 27–32 week gestation without other major perinatal conditions or problems. The data were compared between babies with FGR (n = 30) and age-matched babies without FGR (n = 34) to define any differences.

Results

A notable difference in MLS BAER was found in interpeak intervals between the babies with FGR and those without FGR. The FGR babies manifested significantly shortened I–III interval, moderately prolonged III–V interval, and significantly decreased III–V/I–III interval ratio. The slope of the I–III interval-rate function in FGR babies was moderately decreased, relative to that in the babies without FGR.

Conclusion

FGR babies born very prematurely are associated with accelerated or precocial neural maturation at caudal brainstem regions, but moderately delayed maturation at rostral brainstem regions. The altered brainstem neural maturation is different from previously reported mildly delayed maturation in FGR babies born less prematurely, and may have important implication for neurodevelopmental outcome.

Impact

  • This first MLS BAER study in FGR found that brainstem neural maturation in very premature FGR babies differed from age-matched non-FGR babies.

  • Neural maturation in very premature FGR babies is accelerated or precocial at caudal brainstem regions but moderately delayed at rostral brainstem regions.

  • The altered maturation is different from previously reported mild delay in brainstem neural maturation in FGR babies born less prematurely.

  • FGR exerts a major and differential effect on brainstem neural maturation in babies born very prematurely.

  • This alteration in very premature FGR babies may have important implication for their neurodevelopment.

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Fig. 1: Boxplot of the I–III interval (bold line across the box, median; box, 25th and 75th centile; extensions, the largest and smallest values) at various click rates.
Fig. 2: Boxplot of the III–V interval (bold line across the box, median; box, 25th and 75th centile; extensions, the largest and smallest values) at various click rates.
Fig. 3: Boxplot of the III–V/I–III interval ratio (bold line across the box, median; box, 25th and 75th centile; extensions, the largest and smallest values) at various click rates.

Data availability

The datasets analysed during the current project are available from the corresponding author on reasonable request.

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Acknowledgements

We gratefully acknowledge the doctors and nurses at Neonatal Division of Children’s Hospital for their assistance in recruiting subjects and collecting data.

Author information

Author notes

  1. These authors contributed equally: Ze Dong Jiang, Cui Wang.

Authors and Affiliations

  1. Division of Neonatology, Children’s Hospital of Fudan University, Shanghai, China

    Ze Dong Jiang, Cui Wang, Li Li Ping & Rong Yin

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  1. Ze Dong Jiang
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  2. Cui Wang
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  3. Li Li Ping
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  4. Rong Yin
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Contributions

Z.D.J. designed and supervised the project and was responsible for finalizing the paper. C.W. made major contribution to data collection, analysis and paper writing. L.L.P., R.Y. were responsible for recording and analyzing MLS BAER.

Corresponding author

Correspondence to Ze Dong Jiang.

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Jiang, Z.D., Wang, C., Ping, L.L. et al. Altered maturation in brainstem neural conduction in very premature babies with fetal growth restriction. Pediatr Res (2023). https://doi.org/10.1038/s41390-023-02565-7

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