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J Pediatr. 2013 Dec;163(6):1596-604. doi: 10.1016/j.jpeds.2013.08.011. Epub 2013 Sep 24.

Preterm birth and adolescent social functioning-alterations in emotion-processing brain areas.

Author information

  • 1Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, United Kingdom; Lucena Clinic Child and Adolescent Mental Health Service, Rathgar, Dublin, Ireland.



To investigate the relationship between preterm birth, adolescent, and adult psychosocial outcomes, and alterations in gray matter volume.


Individuals (n = 73) born at <33 weeks of gestation (very preterm) and 49 controls completed the Child Behavior Checklist (CBCL) at age 15 years to identify 'social immaturity' (SI) cases. Voxel-based morphometry was used to investigate gray matter volumes according to CBCL-SI 'caseness.' The Clinical Interview Schedule-Revised (CIS-R) was administered at age 19 years.


Very preterm adolescents were almost 4 times more likely to reach CBCL-SI 'caseness' compared with controls. Ex-preterm SI 'cases' had increased gray matter volume in the fusiform gyrus bilaterally (Talairach coordinates: x = 60, y = -27, z = -30; Z = 3.78; x = -61, y = -35, z = -27; Z = 3.56, after correction for multiple comparisons) compared with ex-preterm SI 'noncases.' Left fusiform volume displayed a stronger correlation with ipsilateral orbitofrontal cortex in SI 'cases' (x = -15, y = 22, z = -26; Z = 3.64). CIS-R total scores were slightly higher in ex-preterm individuals compared with controls. In the whole sample, SI 'cases' in midadolescence also had higher CIS-R scores in adulthood compared with 'noncases' (SI 'cases': mean = 5.7, 95% CI = 4.0-7.4; SI 'noncases': mean = 2.7, 95% CI = 1.1-4.3; F = 6.4, df = 74; P = .013).


Ex-preterm adolescents had increased socialization problems in adolescence, which were associated with volumetric alterations in an emotion-processing brain network. Atypical social development is linked to an increased vulnerability to psychiatric disorder.

Copyright © 2013 Mosby, Inc. All rights reserved.


ASD; Autism spectrum disorder; CBCL; CIS-R; Child Behavior Checklist; Clinical Interview Schedule-Revised; FWE; Family wise error; MRI; Magnetic resonance imaging; SES; SI; Social economic status; Social immaturity; VPT; Very preterm

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