2024

Background information

Preterm birth, being born before your due date, can be associated with changes to brain development and challenges during childhood and beyond. A family’s socioeconomic status (SES) describes a family’s access to financial, educational, social, and health resources. Being born into a family affected by low SES can also be associated with difficulties in development.

Inflammation is the way the body’s immune system responds to infection, injuries, and other experiences that can damage the body. Inflammation might be one way that preterm birth and low SES might affect development.

Epigenetic changes are ways that the environment and experiences affect how your genes in your DNA are used, without changing the DNA itself. Scientists have created epigenetics scores, known as EpiScores, for various proteins in the blood, and these EpiScores might be better than the proteins themselves for investigating how inflammation affects the body, particularly the brain. Within the Theirworld Edinburgh Birth Cohort, we have calculated these EpiScores using saliva samples taken when babies reached their due date.

We have previously shown that one of these EpiScores was associated with preterm birth, brain changes after preterm birth, and various illnesses we see in preterm-born infants.

Research question

We investigated whether preterm birth and low SES were associated with 104 EpiScores, including inflammation-related proteins.

Findings

Preterm birth was linked to 43 EpiScores, representing proteins responsible for infection and inflammation responses, and development of the brain, blood vessels and other body systems.

Only three EpiScores were linked to low SES, and when we took into account the illnesses we see in infants born preterm, these links disappeared.

Conclusion

A range of proteins are linked to preterm birth – this helps us understand how the immune system is changed when babies are born early.

However, there are very few protein EpiScores linked to low SES, so it is unlikely that inflammation is the main reason why low SES affects the development of preterm infants in the neonatal period.

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Babies' attachment to their caregivers at nine months is not affected by how their brains' amygdala and hippocampus are shaped and connected at birth.

Background information.

Attachment refers to one aspect of the relationship between an infant and a caregiver that is related to making the child feel safe and protected. Infants who feel secure around caregivers are better at handling emotions and getting along with others as they grow up. However, prematurity can affect how babies develop socially and emotionally.

It is possible that infants are born with traits that help them attach securely to their caregivers. Differences in attachment might come from how infants react to stress and how they interpret care from their parents. The development of some parts of the infant’s brain – like the amygdala and hippocampus – has been associated with stress during pregnancy, infants’ fear expression and parental care early in life. Prematurity might also affect how these brain regions develop.

Research question.

We wanted to determine if the development of the amygdala, hippocampus, or their whole-brain connections at birth influences attachment in term and preterm infants later on. Understanding which parts of the brain are linked to attachment and what affects them can help us find ways to support babies’ socioemotional growth. To address this, we conducted brain MRI scans at birth and observed how babies reacted when their caregiver briefly stopped interacting with them at nine months.

Findings.

We did not find any significant links between the size or connections of the amygdala and hippocampus at birth and babies’ distress, anger or attention to their caregiver during the 9-month test. Importantly, these results applied to both preterm and term babies. This suggests that the way babies form attachments might involve more parts of the brain or develop later in life rather than being determined by these specific brain structures early on.

Conclusion.

If more studies demonstrate that infants’ natural traits around birth – like brain structure – do not play a big role in how they attach to their caregivers, strategies trying to support infant socio-emotional growth could focus more on how parents care for the baby after birth. By paying attention to how parents interact with their babies, we may be able to help term and preterm infants develop socially and emotionally in a positive way.

Studying How Being Born Early Affects Cerebral Cortex Development in Babies

Background information.

The cerebral cortex is the outer layer of the brain, playing a key role in memory, attention, perception, awareness, thought, language, and consciousness. Different parts of the cortex have specific functions: the temporal lobe handles hearing and memory, the occipital lobe processes visual information, the frontal lobe is involved in decision making and movement, and the parietal lobe integrates sensory information. In the last few months before birth and shortly after, the brain undergoes rapid development. Being born early (preterm) can interrupt this crucial period, potentially affecting lifelong brain function and development.

Research question.

We aimed to investigate how being born preterm affects the detailed structure of the brain at the time of normal birth (term-equivalent age) using a new measurement method called the Vogt-Bailey (VB) index.

Findings.

The study found that preterm babies have different microscopic details in brain structures in several areas compared to full-term babies, with more uniform structures in parts of the temporal, occipital, frontal, and parietal lobes. The VB index provided a detailed and reliable way to see these differences, offering better precision than previous methods. These findings were consistent across two different groups of babies, ensuring the reliability of the results.

Conclusion.

Understanding how preterm birth affects brain development can help identify early signs of potential cognitive or functional issues. This knowledge can guide interventions and support for preterm babies. Future studies could use the VB index to link early brain differences to long-term outcomes, leading to strategies that help preterm babies develop as healthily as possible.

A ball-bearing found in a child’s ear at a research MRI

Background information.

In this article, we discuss a child who attended his research MRI at five years of age and was found to have an unexpected 5mm ball bearing in his ear. It was found when he approached the MRI scanner, and the magnet dislodged the ball bearing. 

Description. ​​​

We used magnetic resonance imaging (MRI) scans regularly to study the brains development after preterm birth, and found they are generally very safe, with no radiation exposure. Metal “foreign bodies” and implants can be a safety risk when performing MRIs, because of the magnet strength involved in taking pictures of the brain. Risks are reduced by thorough safety checks, including questions about any possible metal, both intentionally put there by doctors or surgeons, and unintentionally through putting objects in ears or nostrils, or swallowing. We also use visual checks before starting a scan.  We then discuss some of the wider research about making MRI scans as safe as possible for children.

Since this child’s ball bearing, we now additionally use a magnet wand to check for any metal objects in ears or nostrils before children enter the MRI scanner.

Conclusion.

This project has shown the importance of thorough safety screening, particularly in young children or those with cognitive or behavioural problems who are more likely to have “foreign bodies”, but that there is no perfect screening method to prevent all unexpected metal. We hope that sharing our experience will contribute to MRI safety worldwide.