Grant: Project Grant

In Canada, as in other high resource countries, preterm birth (<37 weeks gestation) is the most important cause of disability. Among children born preterm >50% show significant developmental problems (cognitive, attention, behaviour, social, motor, academic) impacting family and society. While abnormal brain development is evident in these vulnerable children, persisting to adulthood, little is known about why some preterm children do well and others decline, even when born in the same gestational age range. Early stress impacts brain structure and function. Children born very preterm (<32 weeks gestation) are exposed to pain-related stress of medical and nursing procedures (~10 per day) during weeks to months in the neonatal intensive care unit (NICU). Our research has shown that this neonatal pain/stress is associated with altered brain development and stress hormone (cortisol) regulation, beyond clinical factors related to premature birth. The goal of this project is to determine in a longitudinal prospective study of children born very preterm (24-32 weeks) how the developing brain and stress systems may affect the pattern of cognitive and behavioral outcomes across ages 1.5, 3, 4.5 and 8 years, the role of parenting, and whether effects differ by sex. Understanding factors that explain the wide variation in neurodevelopmental outcomes in children born preterm, and that promote stress regulation and brain recovery in children born very preterm will provide critical underpinnings for developing interventions to optimize long-term neurodevelopment in this fragile population.