Behavioral outcome of very preterm children at 5 years of age: Prognostic utility of brain tissue volumes at term‐equivalent‐age, perinatal, and environmental factors
Abstract Objective Prematurity is associated with a high risk of long‐term behavioral problems. This study aimed to assess the prognostic utility of volumetric brain data at term‐equivalent‐age (TEA), clinical perinatal factors, and parental social economic risk in the prediction of the behavioral o...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Brain and Behavior |
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| Online Access: | https://doi.org/10.1002/brb3.2818 |
| _version_ | 1811164219122384896 |
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| author | Maria Chiara Liverani Serafeim Loukas Laura Gui Marie‐Pascale Pittet Maricé Pereira Anita C. Truttmann Pauline Brunner Myriam Bickle‐Graz Petra S. Hüppi Djalel‐Eddine Meskaldji Cristina Borradori‐Tolsa |
| author_facet | Maria Chiara Liverani Serafeim Loukas Laura Gui Marie‐Pascale Pittet Maricé Pereira Anita C. Truttmann Pauline Brunner Myriam Bickle‐Graz Petra S. Hüppi Djalel‐Eddine Meskaldji Cristina Borradori‐Tolsa |
| author_sort | Maria Chiara Liverani |
| collection | DOAJ |
| description | Abstract Objective Prematurity is associated with a high risk of long‐term behavioral problems. This study aimed to assess the prognostic utility of volumetric brain data at term‐equivalent‐age (TEA), clinical perinatal factors, and parental social economic risk in the prediction of the behavioral outcome at 5 years in a cohort of very preterm infants (VPT, <32 gestational weeks). Methods T2‐weighted magnetic resonance brain images of 80 VPT children were acquired at TEA and automatically segmented into cortical gray matter, deep subcortical gray matter, white matter (WM), cerebellum (CB), and cerebrospinal fluid. The gray matter structure of the amygdala was manually segmented. Children were examined at 5 years of age with a behavioral assessment, using the strengths and difficulties questionnaire (SDQ). The utility of brain volumes at TEA, perinatal factors, and social economic risk for the prediction of behavioral outcome was investigated using support vector machine classifiers and permutation feature importance. Results The predictive modeling of the volumetric data showed that WM, amygdala, and CB volumes were the best predictors of the SDQ emotional symptoms score. Among the perinatal factors, sex, sepsis, and bronchopulmonary dysplasia were the best predictors of the hyperactivity/inattention score. When combining the social economic risk with volumetric and perinatal factors, we were able to accurately predict the emotional symptoms score. Finally, social economic risk was positively correlated with the scores of conduct problems and peer problems. Conclusions This study provides information on the relation between brain structure at TEA and clinical perinatal factors with behavioral outcome at age 5 years in VPT children. Nevertheless, the overall predictive power of our models is relatively modest, and further research is needed to identify factors associated with subsequent behavioral problems in this population. |
| first_indexed | 2024-04-10T15:18:58Z |
| format | Article |
| id | doaj.art-0a656384e722415cb1640c79b318f53f |
| institution | Directory Open Access Journal |
| issn | 2162-3279 |
| language | English |
| last_indexed | 2024-04-10T15:18:58Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Brain and Behavior |
| spelling | doaj.art-0a656384e722415cb1640c79b318f53f2023-02-14T16:52:40ZengWileyBrain and Behavior2162-32792023-02-01132n/an/a10.1002/brb3.2818Behavioral outcome of very preterm children at 5 years of age: Prognostic utility of brain tissue volumes at term‐equivalent‐age, perinatal, and environmental factorsMaria Chiara Liverani0Serafeim Loukas1Laura Gui2Marie‐Pascale Pittet3Maricé Pereira4Anita C. Truttmann5Pauline Brunner6Myriam Bickle‐Graz7Petra S. Hüppi8Djalel‐Eddine Meskaldji9Cristina Borradori‐Tolsa10Division of Development and Growth, Department of Pediatrics University of Geneva Geneva SwitzerlandDivision of Development and Growth, Department of Pediatrics University of Geneva Geneva SwitzerlandDivision of Development and Growth, Department of Pediatrics University of Geneva Geneva SwitzerlandDivision of Development and Growth, Department of Pediatrics University of Geneva Geneva SwitzerlandDivision of Development and Growth, Department of Pediatrics University of Geneva Geneva SwitzerlandClinic of Neonatology, Department of Women Mother Child University Center Hospital and University of Lausanne Lausanne SwitzerlandClinic of Neonatology, Department of Women Mother Child University Center Hospital and University of Lausanne Lausanne SwitzerlandFollow Up Unit, Department of Women Mother Child University Center Hospital and University of Lausanne Lausanne SwitzerlandDivision of Development and Growth, Department of Pediatrics University of Geneva Geneva SwitzerlandDivision of Development and Growth, Department of Pediatrics University of Geneva Geneva SwitzerlandDivision of Development and Growth, Department of Pediatrics University of Geneva Geneva SwitzerlandAbstract Objective Prematurity is associated with a high risk of long‐term behavioral problems. This study aimed to assess the prognostic utility of volumetric brain data at term‐equivalent‐age (TEA), clinical perinatal factors, and parental social economic risk in the prediction of the behavioral outcome at 5 years in a cohort of very preterm infants (VPT, <32 gestational weeks). Methods T2‐weighted magnetic resonance brain images of 80 VPT children were acquired at TEA and automatically segmented into cortical gray matter, deep subcortical gray matter, white matter (WM), cerebellum (CB), and cerebrospinal fluid. The gray matter structure of the amygdala was manually segmented. Children were examined at 5 years of age with a behavioral assessment, using the strengths and difficulties questionnaire (SDQ). The utility of brain volumes at TEA, perinatal factors, and social economic risk for the prediction of behavioral outcome was investigated using support vector machine classifiers and permutation feature importance. Results The predictive modeling of the volumetric data showed that WM, amygdala, and CB volumes were the best predictors of the SDQ emotional symptoms score. Among the perinatal factors, sex, sepsis, and bronchopulmonary dysplasia were the best predictors of the hyperactivity/inattention score. When combining the social economic risk with volumetric and perinatal factors, we were able to accurately predict the emotional symptoms score. Finally, social economic risk was positively correlated with the scores of conduct problems and peer problems. Conclusions This study provides information on the relation between brain structure at TEA and clinical perinatal factors with behavioral outcome at age 5 years in VPT children. Nevertheless, the overall predictive power of our models is relatively modest, and further research is needed to identify factors associated with subsequent behavioral problems in this population.https://doi.org/10.1002/brb3.2818behavioral outcomeclassificationmachine learningMRIpreterm infantsvolumetric brain data |
| spellingShingle | Maria Chiara Liverani Serafeim Loukas Laura Gui Marie‐Pascale Pittet Maricé Pereira Anita C. Truttmann Pauline Brunner Myriam Bickle‐Graz Petra S. Hüppi Djalel‐Eddine Meskaldji Cristina Borradori‐Tolsa Behavioral outcome of very preterm children at 5 years of age: Prognostic utility of brain tissue volumes at term‐equivalent‐age, perinatal, and environmental factors Brain and Behavior behavioral outcome classification machine learning MRI preterm infants volumetric brain data |
| title | Behavioral outcome of very preterm children at 5 years of age: Prognostic utility of brain tissue volumes at term‐equivalent‐age, perinatal, and environmental factors |
| title_full | Behavioral outcome of very preterm children at 5 years of age: Prognostic utility of brain tissue volumes at term‐equivalent‐age, perinatal, and environmental factors |
| title_fullStr | Behavioral outcome of very preterm children at 5 years of age: Prognostic utility of brain tissue volumes at term‐equivalent‐age, perinatal, and environmental factors |
| title_full_unstemmed | Behavioral outcome of very preterm children at 5 years of age: Prognostic utility of brain tissue volumes at term‐equivalent‐age, perinatal, and environmental factors |
| title_short | Behavioral outcome of very preterm children at 5 years of age: Prognostic utility of brain tissue volumes at term‐equivalent‐age, perinatal, and environmental factors |
| title_sort | behavioral outcome of very preterm children at 5 years of age prognostic utility of brain tissue volumes at term equivalent age perinatal and environmental factors |
| topic | behavioral outcome classification machine learning MRI preterm infants volumetric brain data |
| url | https://doi.org/10.1002/brb3.2818 |
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