Associations Among Birth Weight, Adrenarche, Brain Morphometry, and Cognitive Function in Preterm Children Ages 9 to 11 Years

BACKGROUND: Preterm infants with low birth weight are at heightened risk of developmental sequelae, including neurological and cognitive dysfunction that can persist into adolescence or adulthood. In addition, preterm birth and low birth weight can provoke changes in endocrine and metabolic processes that likely impact brain health throughout development. However, few studies have examined associations among birth weight, pubertal endocrine processes, and long-term neurological and cognitive development. METHODS: We investigated the associations between birth weight and brain morphometry, cognitive function, and onset of adrenarche assessed 9 to 11 years later in 3571 preterm and full-term children using the ABCD (Adolescent RESULTS: The preterm children showed lower birth weight and early adrenarche, as expected. Birth weight was positively associated with cognitive function (all Cohen's d> 0.154, p < .005), global brain volumes (all Cohen's d> 0.170, p < .008), and regional volumes in frontal, temporal, and parietal cortices in preterm and full-term children (all Cohen's d> 0.170, p < .0007); cortical volume in the lateral orbitofrontal cortex partially mediated the effect of low birth weight on cognitive function in preterm children. In addition, adrenal score and cortical volume in the lateral orbitofrontal cortex mediated the associations between birth weight and cognitive function only in preterm children. CONCLUSIONS: These findings highlight the impact of low birth weight on long-term brain structural and cognitive function development and show important associations with early onset of adrenarche during the puberty. This understanding may help with prevention and treatment.