Abstract

Objectives: To assess radiographic brain abnormalities and investigate volumetric differences in adults born preterm at very low birth weight (<1500 g), using siblings as controls.

Study design: We recruited 79 adult same-sex sibling pairs with one born preterm at very low birth weight and the sibling at term. We acquired 3-T brain magnetic resonance imaging from 78 preterm participants and 72 siblings. A neuroradiologist, masked to participants’ prematurity status, reviewed the images for parenchymal and structural abnormalities, and FreeSurfer software 6.0 was used to conduct volumetric analyses. Data were analyzed by linear mixed models.

Results: We found more structural abnormalities in very low birth weight participants than in siblings (37% vs 13%). The most common finding was periventricular leukomalacia, present in 15% of very low birth weight participants and in 3% of siblings. The very low birth weight group had smaller absolute brain volumes (−0.4 SD) and, after adjusting for estimated intracranial volume, less gray matter (−0.2 SD), larger ventricles (1.5 SD), smaller thalami (−0.6 SD), caudate nuclei (−0.4 SD), right hippocampus (−0.4 SD), and left pallidum (−0.3 SD). We saw no volume differences in total white matter (−0.04 SD; 95% CI, −0.13 to 0.09).

Conclusions: Preterm very low birth weight adults had a higher prevalence of brain abnormalities than their term-born siblings. They also had smaller absolute brain volumes, less gray but not white matter, and smaller volumes in several gray matter structures.