Researchers are working to develop biomarkers to identify and treat at-risk preterm infants.
For years, studies have indicated a direct link between preterm births and a higher risk for cognitive problems and behavioral disorders later in life. It's been far less clear attempting to predict which babies are at risk and how adversely they may be affected.
But researchers at Children's Hospital Los Angeles (CHLA) are working to shift that paradigm by developing biomarkers to identify, and ultimately treat, at-risk preterm infants.
"There are a lot of premature children each year—one in nine babies is born premature—so we can't treat everyone for every condition that has been associated with prematurity," says Natasha Leporé, Ph.D., a principal investigator in the Department of Radiology at CHLA. "Instead, we need to have a way to know which ones need a particular treatment, and that's what we're trying to do with this study."
The National Institute of Biomedical Imaging and Bioengineering of the NIH recently awarded $1.7 million to Leporé and her team for the study. CHLA's MRI scanning technology and experience among its staff positions the hospital to conduct this research, Leporé says.
Over the four-year grant period, researchers will conduct MRI brain scans of about 90 preterm infants at CHLA. They are also acquiring previously collected scans from Children's Hospital of Pittsburgh of UPMC.
Follow-up neuropsychological testing will be administered at various age benchmarks for all scanned subjects. The data will then be run through multiple algorithms to build the predictive datasets that will eventually guide doctors toward early-intervention treatments for these high-risk babies. This analysis will be performed in collaboration with Dr. Yalin Wang's laboratory at Arizona State University.
"That's why we need these precise measures on subcortical structure," Leporé says. "We need to be able say, 'When a kid has this particular pattern of injury, we can predict they're going to have this problem.' What we would do for a child at risk for ADHD is different than what we'd do for a child at risk for cerebral palsy—we want them getting the correct services."
Early intervention is key
Perhaps most notably, the ability to intervene at an early age could have a profound effect on these children. "It would lead to better outcomes if we can have these children scanned at an earlier age," Leporé says. "A lot of treatments work really well if they're started early. Ultimately, it would be a tremendous help for them, their families and the system."
Leporé says the ability to predict long-term neurodevelopmental outcomes—coupled with the possibility that creates for early intervention—can have a "transformative effect" on outcomes for preterm babies.
And the significance of the potential impact of the work isn't lost on those conducting the research. "It's very satisfying," Leporé says. "I work in a children's hospital, and every day I see all these kids with so many different problems. If we can do something, even a small thing, to help some kids, it's wonderful."
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