Socioeconomic status associated with impact of brain injury on preterm babies

Study shows cognitive scores for preterm children with higher socioeconomic status are similar regardless of whether they had a brain injury

TORONTO – Babies born prematurely are at a high risk for brain injury. While improved intensive care therapies have increased the survival rates of these patients, many face cognitive challenges later in life. New research from The Hospital for Sick Children (SickKids) and BC Children’s Hospital shows there may be an association between higher socioeconomic status and reduced impact of brain injury. The study was published online in JAMA Network Open on May 3, 2019.

The researchers wanted to understand the role of environments and experiences in moderating neurodevelopmental disability. While previous experimental studies have indicated enriched environments can mitigate the impact of brain injuries, little is understood about the particular impact of socioeconomic status on brain injuries in children who are born preterm.

“Despite all our advances, brain injury in preterm infants can still have a significant long-term impact on children’s cognition,” says Dr. Steven Miller, co-Principal Investigator of the study, Head of Neurology and Senior Scientist in Neuroscience and Mental Health at SickKids. “It’s important that we focus on identifying modifiable factors that might enhance brain development and improve quality of life.”

The researchers completed full neurodevelopmental assessments at 1.5, 3 and 4.5 years of age for 170 children at BC Children’s Hospital who were born prematurely between 24 and 32 weeks’ gestational age. They used maternal education at the time of the infants’ births as their primary measure of socioeconomic status.

The team found maternal education had as important an association with cognitive outcomes as brain injury itself. Strikingly, the association of brain injury with cognitive outcomes was modified by socioeconomic status; as a result, brain injury did not predict lower cognitive scores in children born to the mothers with the highest level of education. These findings illustrate that both socioeconomic status and brain injury are of comparable importance and may even have the ability to influence one another when it comes to neurodevelopmental disability, the researchers say.

“Many factors likely underlie effects of maternal education on preterm infant development, including parenting stress,” says Dr. Ruth Grunau, co-Principal Investigator of the study, Senior Scientist at BC Children’s Hospital and Professor in the Department of Paediatrics at the University of British Columbia. “Factors that we think may enhance brain development include supporting parents to be actively involved in their preterm infant’s care. Families with higher socioeconomic status likely have more resources that facilitate spending time with their baby while they are hospitalized and once home.”

The next step in this research, the scientists note, is to identify the specific elements that differ in the experiences of children born to mothers with higher levels of education. Then the effectiveness of interventions can be evaluated.

This study was supported by the Canadian Institutes for Health Research (CIHR),the Kids Brain Health Network and SickKids Foundation.

About The Hospital for Sick Children (SickKids)

The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is a founding member of Kids Health Alliance, a network of partners working to create a high quality, consistent and coordinated approach to pediatric health care that is centred around children, youth and their families. SickKids is proud of its vision for Healthier Children. A Better World.

Media contact:
Jessamine Luck
The Hospital for Sick Children (SickKids)
416-813-7654 ext. 201436
jessamine.luck@sickkids.ca