초극소 미숙아로 출생한 만 6세 아동의 지능과 뇌백질 발달: 극소 미숙아와의 비교 분석

Abstract

Objective: This study aimed to investigate intelligence and brain white matter development in extremely preterm children at school age compared to same-aged very preterm children born above 28 weeks of gestation. Methods: This study included children without brain injury on neonatal neuroimaging and severe neurological disability at 6 years of age, who were born <32 weeks of gestation and admitted to the neonatal intensive care unit between 2010 and 2013. Intelligence was assessed by Korean-Wechsler Intelligence Scale for Children-4th edition (K-WISC-IV). The fractional anisotropy images of the diffusion tensor imaging were used in the tract-based spatial statistics (TBSS). All children were divided into the extremely preterm children group (EPT) born <28 weeks of gestation and the very preterm children group (VPT) born 28 to 31 weeks of gestation. The data of K-WISC-IV and TBSS were compared between 2 groups. Results: A total of 34 children (EPT, 20; VPT, 14) were included. EPT showed lower perceptual reasoning index scores (82.7±13.9 vs. 97.9±12.3, P=0.002) and higher rates of borderline or delayed perceptual reasoning function (50.0% vs. 0%, P=0.002) compared to VPT; however, full-scale intelligence quotient was not significantly different. TBSS demonstrated the underdeveloped body and splenium of the corpus callosum in EPT compared to VPT. Conclusion: EPT showed delayed function at perceptual reasoning and immaturity of the corpus callosum compared to VPT. Gestational age affects subscale of intelligence and development of the corpus callosum in generally healthy children born <32 weeks of gestation.