Abstract P-531: BEHAVIORAL SIGNS OF STRESS IN PRETERM INFANTS DURING ADMISSION TO A NEONATAL INTENSIVE CARE UNIT AND EARLY BRAIN DEVELOPMENT

Abstract

Aims & Objectives: Preterm birth presents a high risk of delay across multiple domains of development that is associated with underlying disturbances in brain maturational patterns. Early stressful experiences in the vulnerable period following preterm birth may contribute to structural and functional brain abnormalities. Aim of the study is to investigate the association between neonatal stress of extremely preterm infants during their NICU stay and early brain development on MRI. Methods In this retrospective study, 123 extremely preterm infants (GA 26,47 ± 0,10; BW_z-scores 0,15 ± 0,11) admitted to the Wilhelmina Children’s Hospital between January 2012 and May 2015 were included. All underwent cranial MRI at term equivalent age (TEA). Stress responses were measured with the COMFORT-Neo scale during the first two weeks of admission; scores were classified as low/mild (<12), moderate (≥12 to <14) and high (≥14). Brain volumes and cortical morphology descriptors were computed as used previously. General linear models were used to determine the influence of stress scores on neurostructural outcomes adjusting for potential clinical confounders. Results High stress responses showed a negative association at TEA with mean curvature (np2 .140; p <.001) and unmyelinated white matter volumes (np2 .050; p= .001), while moderate stress responses were related to decreased cerebellar volumes (np2 .070; p<.001). These associations persisted after corrections for prematurity, severity of illness, brain injury, and morphine use. Conclusions Neonatal stress in the first two weeks after preterm birth has a significant effect on brain volumes and on cortical morphology measures at TEA, with differential effects on brain tissues exerted by distinct qualities of stress.