Grant: Operating Grant

In Canada preterm birth is the most important cause of infant death, illness and disability. Children born very early are at very high risk for developmental delays. This risk is increasing over time. In the first phase of our research program, we identified common patterns of brain injury and impaired brain development following preterm birth. How these brain abnormalities in the neonatal period relate to long-term brain changes and long-term outcomes is unknown. To our knowledge, ours is the only cohort of premature newborns serially studied with advanced brain imaging in the neonatal period and followed in early childhood with measures of stress system function that can be re-examined at 8 years of age with detailed advanced brain imaging and outcome measures to address these critical questions. The overall hypothesis of this research is that brain injury and altered brain development, in association with systemic illness, results in long-term changes in motor and cognitive function, and that this relationship is modulated by permanent changes in stress hormone levels. Building on the platform of our unique cohort, we are now positioned to address our overall objective of determining why and how children born very early are so developmentally vulnerable. A better understanding of the factors that effect long-term brain development will allow us to directly improve the neurodevelopmental outcome of preterm newborns by targeting those factors that promote good outcomes. The development of robust measures of brain development and injury in newborns will help parents and health care providers to care for newborns delivered preterm by providing important long-term prognostic information, and early identification of those children most in need of intervention to optimize neurodevelopment.