Project 454474

The rate of preterm birth in Canada is 8% with 1 in 12 infants being born too soon. Preterm infants are at risk for brain injury which can lead to motor impairment and cerebral palsy. In addition, children born preterm can have cognitive and language delays and hearing and vision loss. Preterm birth can cause significant disability which can negatively impact the child and their family. Previous studies of preterm infants have followed children up to 3-years of age, and later childhood outcomes are not well known. While the risk for brain injury in preterm infants is well documented, less is known about their subsequent brain development. Biological sex has been shown to influence outcomes, with preterm males at increased risk for brain injury and poor outcomes, relative to preterm females. Differences in long-term outcomes and brain development between preterm males and females are not well known. In the proposed study we will compare brain development and clinical outcomes between preterm males and females followed to 8-years of age. Study participants will be selected two preterm cohorts with infants born 24-32 weeks gestational age, who were recruited from two neonatal intensive care units. Children will have regular assessments of their cognitive, language and motor abilities from 18-months to 8-years of age. Brain growth and maturation will be assessed using specialized MRI scans at the time of birth and at 8-years of age. Clinical outcomes, brain growth and maturation will be compared between preterm males and females. This will be the first preterm cohort study to follow children from birth to 8-years of age with both clinical and advanced neuroimaging assessments. This study will improve our understanding of how biological sex influences brain development and long-term outcomes. Understanding which children are at risk will allow clinicians to better support these children and implement targeted interventions to improve outcomes.