BackgroundFifteen million infants annually are born prematurely, placing them at high risk for life‐long adverse neurodevelopmental outcomes. Whether brain tissue abnormalities that accompany preterm birth persist into young adulthood and are associated with long‐term cognitive or psychiatric outcomes is not known.MethodsFrom infancy into young adulthood, we followed a population‐based sample of consecutively identified preterm infants and their matched term controls. The preterm group was born at an average gestational age of 31.5 ± 2.6 weeks. We obtained Diffusion Tensor Imaging scans and assessed cognitive and psychiatric outcomes in young adulthood, at a mean age of 19 (range 17.6–20.8) years. Usable data were acquired from 180 participants (89 preterm, 91 term).ResultsPreterm birth was associated with lower fractional anisotropy (FA) and higher average diffusion coefficient (ADC) values in deep white matter tracts of the internal capsule, cerebral peduncles, inferior frontal‐occipital fasciculus, sagittal stratum and splenium of the corpus callosum, as well as in grey matter of the caudate, putamen and thalamus. A younger gestational age at birth accentuated these tissue abnormalities. Perinatal characteristics, including lower 5‐min APGAR score, history of bronchopulmonary dysplasia, more days of oxygen supplementation and multiple births all increased ADC values in deep white matter tracts and grey matter throughout the brain. Preterm individuals had significantly lower full‐scale IQ and more frequent lifetime psychiatric disorders. Those with psychiatric illnesses had significantly higher ADC and lower FA values throughout the deep posterior white matter.ConclusionsAbnormalities in brain tissue microstructure associated with preterm birth persist into young adulthood and likely represent disordered myelination and accompanying axonal pathology. These disturbances are associated with a higher likelihood of developing a psychiatric disorder by young adulthood. Brain tissue disturbances were accentuated in those born at younger gestational ages and in those with a history of perinatal complications associated with infection and inflammation.

中文翻译：

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早产儿和足月出生的年轻人的前瞻性、纵向、基于人群的队列中的脑组织微结构


背景每年有 1500 万婴儿早产，这使他们处于终生不良神经发育结局的高风险中。早产伴随的脑组织异常是否持续到成年早期，并与长期认知或精神结局有关尚不清楚。方法从婴儿期到成年早期，我们跟踪了连续确定的早产儿及其匹配的足月对照的人群样本。早产儿组的平均胎龄为 31.5 ± 2.6 周。我们获得了弥散张量成像扫描，并评估了平均 19 岁 （范围 17.6-20.8） 岁青年期的认知和精神结局。从 180 名参与者 （89 名早产儿，91 名足月） 中获取可用数据。结果早产与内囊深部白质束、脑蒂、额枕下束、矢状层和胼胝体胼胝体以及尾状核、壳核和丘脑灰质的各向异性分数 （FA） 和较高的平均弥散系数 （ADC） 值相关。出生时胎龄较小会加剧这些组织异常。围产期特征，包括较低的 5 分钟 APGAR 评分、支气管肺发育不良病史、补充氧气天数增加和多胞胎都增加了深部白质束和整个大脑灰质的 ADC 值。早产儿的全 IQ 显著降低，终生精神疾病更频繁。患有精神疾病的患者在整个深部后白质中具有显着较高的 ADC 和较低的 FA 值。结论与早产相关的脑组织微结构异常持续到成年早期，可能代表髓鞘形成紊乱和伴随的轴突病变。这些障碍与成年早期患精神疾病的可能性更高有关。在胎龄较小出生的人群和有感染和炎症相关围产期并发症史的人群中，脑组织紊乱更加严重。