TOP 64 - Resting-state functional magnetic resonance imaging in moderate to late preterm infants and associations with motor development at 2 years.

Publication Number: 3795.TOP 64

Claire Donnici, University of Calgary, Calgary, AB, Canada; Anouk S.. Verschuur, Isala Hospital, Deventer, Overijssel, Netherlands; Alice Holub, university of calgary, Calgary, AB, Canada; Regan King, University of Ca=ary Cumming School of Medicine, Calgary, AB, Canada; Aliza Jaffer, University of Calgary, Calgary, AB, Canada; Leonora Hendson, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada; Gerda Meijler, Leiden University Medical Center, Zwolle, Overijssel, Netherlands; Lara M. Leijser, University of Calgary, Calgary, AB, Canada

Background: Infants born moderate to late preterm (MLPT; 32-36 weeks’ gestation) comprise 84% of all preterm births, accounting for 13 million births worldwide per year. Despite evidence that MLPT birth confers risk for developmental delays compared to term birth, there is limited knowledge about the mechanisms underlying these neurodevelopmental differences as prior studies have focused on extremely or very preterm infants. Evidence suggests that MLPT infants have reduced functional connectivity across resting state networks compared to term-born infants. Whether alterations in network connectivity contribute to developmental outcomes in MLPT-born children is unknown. The motor network is one of the earliest functional networks to show coordinated activity, with maturity resembling adult topology by term equivalent age (TEA). Studying the motor network using resting-state functional magnetic resonance imaging (rs-fMRI) can provide insight into the relationship between MLPT birth and later motor skills, which may facilitate early detection of delays and timely interventions.

Objective: Compare functional connectivity and network characteristics between term-born control and MLPT infants and evaluate the relationship between network connectivity in the motor network and motor development at 2 years.

Design/Methods: This work is part of a prospective cohort study, the Brain Imaging in MLPT infants (BIMP) study, evaluating neurodevelopment in MLPT infants using MRI and longitudinal follow-up. Rs-fMRI scans were performed at TEA in 120 MLPT and 28 term-born control infants during natural sleep. Images underwent motion correction, spatial smoothing, and high pass temporal filtering. Images from 86 MLPT infants (mean gestational age (GA) 34.5 +/- 1.1 weeks; postmenstrual age (PMA) at MRI 42 +/- 1.5 weeks) and 26 term-born infants (mean GA 39 +/- 0.4 weeks; PMA at MRI 43 +/- 1.0 weeks) were included in the analysis. Images were excluded based on poor quality or excessive motion. Motor regions from a neonate atlas were registered to individual images. Motor development was evaluated using the Bayley Scales of Infant Development (4th Ed) at 2 years corrected age. By January 2026, average functional connectivity and network characteristics, such as local and global efficiency and modularity, will be extracted from the motor network and compared between MLPT and term-born infants using regression models. Regression and moderation analysis will be used to study the relationship between motor network connectivity and 2 year motor outcomes. The University of Calgary Research Ethics Board approved this study.