Objective To characterise white matter microstructural differences within very preterm (VPT; <33 weeks’ gestational age) infants that develop motor impairment in the first 2 years of life. Design Cohort study, VPT infants (Cincinnati Infant Neurodevelopment Early Prediction Study) recruited from five level III/IV neonatal intensive care units in the greater Cincinnati area between September 2016 and November 2019. Setting Multicentre study; participants received MRI at term-equivalent age at Cincinnati Children’s Hospital Medical Center and were followed-up at 2 years corrected age to assess their motor performance. Patients Infants born before 33 weeks were eligible. Main outcomes and measures Composite motor scores at 2 years corrected age (CA) on the Bayley Scales of Infant and Toddler Development, III. Fractional anisotropy (FA) along the white matter tracts was used to measure white matter microstructure. Motor impairment was defined as Bayley-III motor score <85. Results 247 controls and 84 impaired infants were included in the study. Compared with the controls, infants with motor impairment were characterised by location-dependent credible group differences and significantly lower FA in both sensorimotor and non-sensorimotor tracts. A location-specific significant positive association between FA and Bayley scores in the impaired group was observed in multiple sensorimotor tracts and non-sensorimotor tracts. No significant associations were found between FA and Bayley scores in the controls. Conclusion VPT infants developing motor impairments show altered inter and intrahemispheric connectivity, with early indications of impaired visual-motor, sensorimotor and thalamo-cortical connectivity, extending beyond sensorimotor tracts.
Joshi et al. (2026) studied this question.