When premature babies are exposed to more stress while in hospital, it has a negative effect on their brain development. This has been shown by researcher Femke Lammertink of UMC Utrecht in her PhD research. Some of these young patients may develop mental problems when they are toddlers or infants as a result. 

To give premature babies the best possible start, doctors and nurses want to help these babies and their parents as early as possible to reduce the effects of stress. Researcher Femke Lammertink of Utrecht University therefore delved into the special mechanism of the baby brain. She did so under the guidance of UMC Utrecht neonatology professor Manon Benders, in close collaboration with researchers from Radboudumc and Amsterdam UMC. The findings were published this month in The Journal of Neuroscience.

Stress affects growth

In premature babies, researchers see something striking happening. Femke explains: "These newborns are being treated to stay alive. And that, unfortunately, involves stress and discomfort during treatment in the Neonatal Intensive Care Unit." These infants - who come into the world not at 40 weeks but as early as 26 to 28 weeks into pregnancy - sometimes need ventilation and are pricked a lot to tailor treatment to what is needed. Moreover, their parents cannot be around constantly to reassure their newborn. These babies unfortunately go through a lot, and this causes stress. The resilience of these babies varies the research shows. We see the negative effects in some of the group in their growth and development when we do an MRI scan in the 30th and 40th weeks. We do that as standard practice for premature babies at UMC Utrecht." 

MRI scan gives new insights

Thanks to the MRI scan, it has become clear that increase in white matter in these premature babies is slower than normal due to stress, and fewer connections develop between three specific parts of the baby brain." Femke: "Brains consist, in simple terms, of grey and white matter. Nerve cells use their long spur (the axon) to transmit signals to other nerve cells, organs, muscles, or glands. And there are cells that support the neurons in their activity. Among other things, by laying a fatty layer (myelin) around the axon, the maturing white matter. The layer allows a signal to move faster through the body. White matter development starts during pregnancy, but this layer is wafer-thin after birth on all long axons. That brain grows considerably in the first year of life of a healthy child. On brain scans, this is visible by an increase in white matter."

Helping children as early as possible  

"From UMC Utrecht, we follow premature babies until they are 8 years old. We can therefore deduce from the data collected that these children may experience more developmental problems as toddlers (2 to 5 years old). And although we have not yet ruled out other factors, the findings from this study do provide a reason to set up follow-up research. In particular, the question of why some children respond resiliently and experience fewer disadvantages from stress than others is relevant. Is that a matter of genetic predisposition or can factors such as nutrition or sleep or kangeroo care (skin-to-skin contact) make a difference? That requires more research, because doctors and nurses want nothing more than to give premature babies a good start." 

Expertise centre for neonatal neurology

UMC Utrecht has more than 30 rare disorders expertise centres (ECZAs). One of these is the expertise centre for neonatal neurology. In this centre, experts from different specialisms work together to care for newborn children with brain damage or congenital brain abnormalities. They also chart the long-term development of children with brain damage sustained around birth. Together, healthcare providers and researchers ensure good quality care according to the latest medical insights. A golden combination in rare disorders.