Factors Involved in Early Birth May Be Linked to Cerebral Palsy, Other Disorders

Altered functional connectivity in the brains of premature babies is detectable before they are born, according to a study jointly conducted by researchers at Yale School of Medicine, the National Institutes of Health (NIH), and Wayne State University.

The study reporting the findings, “Weak functional connectivity in the human fetal brain prior to preterm birth,” was published in the journal Scientific Reports.

Neurodevelopmental problems are significantly more common in children born prematurely, with studies indicating they are three times more likely to develop cerebral palsy, autism, attention deficit hyperactivity disorders, and other conditions.

In the U.S., 10 to 11 percent of babies are born prematurely. The new study indicates that factors contributing to early birth may also play a role in the brain’s development in the womb, possibly leading to cerebral palsy and other neurodevelopmental disorders.

The team of researchers used a novel fetal resting-state functional Magnetic Resonance Imaging (fMRI) to measure brain function in 32 human fetuses in utero. Fourteen of these fetuses were delivered prematurely (at 24 to 35 weeks). The researchers found that systems-level neural functional connectivity was diminished in fetuses that would subsequently be born preterm.

Neural connectivity was reduced in the left hemisphere pre-language region of the brain, and the degree to which connectivity of this language region extended to the right hemisphere homologs was positively associated with the time elapsed between fMRI assessment and delivery, the researchers found.

“It was striking to see brain differences associated with preterm birth many weeks before the infants were prematurely born,” Dustin Scheinost, lead study researcher at Yale School of Medicine, said in a news release. “Preterm infants are known to have brain changes in language regions, and we were particularly surprised that the fetal differences we detected were in these same language regions.”

Scheinost collaborated with Laura Ment and R. Todd Constable, also researchers at Yale, together with Moriah Thomason from Wayne State University, and Roberto Romero, chief of the perinatology research branch and program director for obstetrics and maternal-fetal medicine of NICHD/NIH.

According to Ment, a professor of pediatrics and neurology at Yale School of Medicine, these findings indicate that some early-birth babies show changes in neural systems even before they are born.

“Impaired connectivity in language regions in infants born long before their due dates needs further study, but is important for future research into both the causes and outcomes of preterm birth,” Ment said.

The future work of the team will address causes of early birth, such as infection and inflammation, to determine whether and how those conditions influence brain development in utero, and the optimal timing for early intervention.

Study participants’ children will continue to be followed so that researchers can determine their long-term outcomes.