Association between postnatal dexamethasone for treatment of bronchopulmonary dysplasia and brain volumes at adolescence in infants born very preterm

Jeanie L Y Cheong, Alice C. Burnett, Katherine J. Lee, Gehan Roberts, Deanne K. Thompson, Stephen J. Wood, Alan Connelly, Peter J. Anderson, Lex W. Doyle, Victorian Infant Collaborative Study Group

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives To compare brain volumes in adolescents who were born extremely preterm (<28 weeks gestation) who had received postnatal dexamethasone, and to determine if there was a postnatal dexamethasone dose-response effect on brain volumes. Study design Geographical cohort study of extremely preterm adolescents born in 1991-1992 in Victoria, Australia. T1-weighted magnetic resonance imaging was performed at 18 years of age. Segmented and parcellated brain volumes were calculated using an automated segmentation method (FreeSurfer) and compared between groups, with and without adjustment for potential confounders. The relationships between total postnatal dexamethasone dose and brain volumes were explored using linear regression. Results Of the 148 extremely preterm participants, 55 (37%) had received postnatal dexamethasone, with a cumulative mean dose of 7.7 mg/kg. Compared with participants who did not receive postnatal dexamethasone, those who did had smaller total brain tissue volumes (mean difference -3.6%, 95% CI [-7.0%, -0.3%], P value =.04) and smaller white matter, thalami, and basal ganglia volumes (all P <.05). There was a trend of smaller total brain and white matter volumes with increasing dose of postnatal dexamethasone (regression coefficient -7.7 [95% CI -16.2, 0.8] and -3.2 [-6.6, 0.2], respectively). Conclusions Extremely preterm adolescents who received postnatal dexamethasone in the newborn period had smaller total brain tissue volumes than those who did not receive postnatal dexamethasone, particularly white matter, thalami, and basal ganglia. Vulnerability of brain tissues or structures associated with postnatal dexamethasone varies by structure and persists into adolescence. 

Original languageEnglish
Pages (from-to)737-743
Number of pages7
JournalJournal of Pediatrics
Volume164
Issue number4
DOIs
Publication statusPublished - Apr 2014
Externally publishedYes

Cite this

Cheong, J. L. Y., Burnett, A. C., Lee, K. J., Roberts, G., Thompson, D. K., Wood, S. J., ... Victorian Infant Collaborative Study Group (2014). Association between postnatal dexamethasone for treatment of bronchopulmonary dysplasia and brain volumes at adolescence in infants born very preterm. Journal of Pediatrics, 164(4), 737-743. https://doi.org/10.1016/j.jpeds.2013.10.083
Cheong, Jeanie L Y ; Burnett, Alice C. ; Lee, Katherine J. ; Roberts, Gehan ; Thompson, Deanne K. ; Wood, Stephen J. ; Connelly, Alan ; Anderson, Peter J. ; Doyle, Lex W. ; Victorian Infant Collaborative Study Group. / Association between postnatal dexamethasone for treatment of bronchopulmonary dysplasia and brain volumes at adolescence in infants born very preterm. In: Journal of Pediatrics. 2014 ; Vol. 164, No. 4. pp. 737-743.
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title = "Association between postnatal dexamethasone for treatment of bronchopulmonary dysplasia and brain volumes at adolescence in infants born very preterm",
abstract = "Objectives To compare brain volumes in adolescents who were born extremely preterm (<28 weeks gestation) who had received postnatal dexamethasone, and to determine if there was a postnatal dexamethasone dose-response effect on brain volumes. Study design Geographical cohort study of extremely preterm adolescents born in 1991-1992 in Victoria, Australia. T1-weighted magnetic resonance imaging was performed at 18 years of age. Segmented and parcellated brain volumes were calculated using an automated segmentation method (FreeSurfer) and compared between groups, with and without adjustment for potential confounders. The relationships between total postnatal dexamethasone dose and brain volumes were explored using linear regression. Results Of the 148 extremely preterm participants, 55 (37{\%}) had received postnatal dexamethasone, with a cumulative mean dose of 7.7 mg/kg. Compared with participants who did not receive postnatal dexamethasone, those who did had smaller total brain tissue volumes (mean difference -3.6{\%}, 95{\%} CI [-7.0{\%}, -0.3{\%}], P value =.04) and smaller white matter, thalami, and basal ganglia volumes (all P <.05). There was a trend of smaller total brain and white matter volumes with increasing dose of postnatal dexamethasone (regression coefficient -7.7 [95{\%} CI -16.2, 0.8] and -3.2 [-6.6, 0.2], respectively). Conclusions Extremely preterm adolescents who received postnatal dexamethasone in the newborn period had smaller total brain tissue volumes than those who did not receive postnatal dexamethasone, particularly white matter, thalami, and basal ganglia. Vulnerability of brain tissues or structures associated with postnatal dexamethasone varies by structure and persists into adolescence. ",
author = "Cheong, {Jeanie L Y} and Burnett, {Alice C.} and Lee, {Katherine J.} and Gehan Roberts and Thompson, {Deanne K.} and Wood, {Stephen J.} and Alan Connelly and Anderson, {Peter J.} and Doyle, {Lex W.} and {Victorian Infant Collaborative Study Group}",
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Cheong, JLY, Burnett, AC, Lee, KJ, Roberts, G, Thompson, DK, Wood, SJ, Connelly, A, Anderson, PJ, Doyle, LW & Victorian Infant Collaborative Study Group 2014, 'Association between postnatal dexamethasone for treatment of bronchopulmonary dysplasia and brain volumes at adolescence in infants born very preterm' Journal of Pediatrics, vol. 164, no. 4, pp. 737-743. https://doi.org/10.1016/j.jpeds.2013.10.083

Association between postnatal dexamethasone for treatment of bronchopulmonary dysplasia and brain volumes at adolescence in infants born very preterm. / Cheong, Jeanie L Y; Burnett, Alice C.; Lee, Katherine J.; Roberts, Gehan; Thompson, Deanne K.; Wood, Stephen J.; Connelly, Alan; Anderson, Peter J.; Doyle, Lex W.; Victorian Infant Collaborative Study Group.

In: Journal of Pediatrics, Vol. 164, No. 4, 04.2014, p. 737-743.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Association between postnatal dexamethasone for treatment of bronchopulmonary dysplasia and brain volumes at adolescence in infants born very preterm

AU - Cheong, Jeanie L Y

AU - Burnett, Alice C.

AU - Lee, Katherine J.

AU - Roberts, Gehan

AU - Thompson, Deanne K.

AU - Wood, Stephen J.

AU - Connelly, Alan

AU - Anderson, Peter J.

AU - Doyle, Lex W.

AU - Victorian Infant Collaborative Study Group

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Y1 - 2014/4

N2 - Objectives To compare brain volumes in adolescents who were born extremely preterm (<28 weeks gestation) who had received postnatal dexamethasone, and to determine if there was a postnatal dexamethasone dose-response effect on brain volumes. Study design Geographical cohort study of extremely preterm adolescents born in 1991-1992 in Victoria, Australia. T1-weighted magnetic resonance imaging was performed at 18 years of age. Segmented and parcellated brain volumes were calculated using an automated segmentation method (FreeSurfer) and compared between groups, with and without adjustment for potential confounders. The relationships between total postnatal dexamethasone dose and brain volumes were explored using linear regression. Results Of the 148 extremely preterm participants, 55 (37%) had received postnatal dexamethasone, with a cumulative mean dose of 7.7 mg/kg. Compared with participants who did not receive postnatal dexamethasone, those who did had smaller total brain tissue volumes (mean difference -3.6%, 95% CI [-7.0%, -0.3%], P value =.04) and smaller white matter, thalami, and basal ganglia volumes (all P <.05). There was a trend of smaller total brain and white matter volumes with increasing dose of postnatal dexamethasone (regression coefficient -7.7 [95% CI -16.2, 0.8] and -3.2 [-6.6, 0.2], respectively). Conclusions Extremely preterm adolescents who received postnatal dexamethasone in the newborn period had smaller total brain tissue volumes than those who did not receive postnatal dexamethasone, particularly white matter, thalami, and basal ganglia. Vulnerability of brain tissues or structures associated with postnatal dexamethasone varies by structure and persists into adolescence. 

AB - Objectives To compare brain volumes in adolescents who were born extremely preterm (<28 weeks gestation) who had received postnatal dexamethasone, and to determine if there was a postnatal dexamethasone dose-response effect on brain volumes. Study design Geographical cohort study of extremely preterm adolescents born in 1991-1992 in Victoria, Australia. T1-weighted magnetic resonance imaging was performed at 18 years of age. Segmented and parcellated brain volumes were calculated using an automated segmentation method (FreeSurfer) and compared between groups, with and without adjustment for potential confounders. The relationships between total postnatal dexamethasone dose and brain volumes were explored using linear regression. Results Of the 148 extremely preterm participants, 55 (37%) had received postnatal dexamethasone, with a cumulative mean dose of 7.7 mg/kg. Compared with participants who did not receive postnatal dexamethasone, those who did had smaller total brain tissue volumes (mean difference -3.6%, 95% CI [-7.0%, -0.3%], P value =.04) and smaller white matter, thalami, and basal ganglia volumes (all P <.05). There was a trend of smaller total brain and white matter volumes with increasing dose of postnatal dexamethasone (regression coefficient -7.7 [95% CI -16.2, 0.8] and -3.2 [-6.6, 0.2], respectively). Conclusions Extremely preterm adolescents who received postnatal dexamethasone in the newborn period had smaller total brain tissue volumes than those who did not receive postnatal dexamethasone, particularly white matter, thalami, and basal ganglia. Vulnerability of brain tissues or structures associated with postnatal dexamethasone varies by structure and persists into adolescence. 

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