Regional Brain Volume Differences Were Associated With Behavioural Outcomes in Children Born Preterm: A Systematic Review

AIM: This systematic review explored associations between brain structural volumes and behavioural outcomes in children born preterm up to 32 weeks of gestation. METHODS: PubMed, PsycINFO, Scopus and Web of Science were searched for papers published in English from 1 January 2013 to 7 November 2023. Studies were included if they examined brain volumetric measures using magnetic resonance imaging and behavioural outcomes from 24 months to 12 years. RESULTS: The search identified 388 records and eight were included. These covered 564 children born at 27-36 weeks, 55.7% of whom were male, with assessments conducted between 2.9 and 10.2 years of age. Three studies were conducted in USA, two in Sweden and one each in Norway, Australia and Switzerland. The findings indicated a higher prevalence of neurodevelopmental and emotional outcomes among children born preterm, particularly autism spectrum disorder, attention deficit hyperactivity disorder and anxiety symptoms. These outcomes were associated with reduced or altered volumes in limbic and subcortical brain regions, such as the amygdala and thalamus. CONCLUSION: Volumetric brain differences were associated with behavioural outcomes and may have reflected early neurobiological vulnerability to later behavioural and emotional difficulties. These findings support early identification of children at risk and targeted intervention strategies.