胎儿生长受限新生儿的海马生长与功能下降：胎羊与早产儿证据

The rate of human brain growth is greatest in mid-to-late fetal gestation, corresponding to peak neuronal dendritogenesis. In pregnancies complicated by fetal growth restriction (FGR) caused by placental dysfunction, brain development is adversely impacted, with evidence of reduced total and hippocampal brain volume in childhood and cognitive deficits. The cellular basis for hippocampal maldevelopment and dysfunction in FGR is unknown.In this study we employed complementary preclinical and clinical investigations of hippocampal developmental trajectory in growth-restricted neonates to address this knowledge gap. In the preclinical study (FGR n = 18, control n = 19), FGR was induced in fetal sheep via surgical induction of placental insufficiency at 89 days’ gestational age (dGA, term is 148 dGA), and after near-term birth (136 dGA), postnatal memory function was measured over 4 weeks. Neuronal dendritogenesis (dendrite length, branching, complexity) was assessed using Golgi–Cox staining of individual hippocampal cornu ammonis 1 (CA1) neurons at two neonatal time points, newborn age at 24 h after birth and 4 weeks of age, to compare the trajectory of hippocampal neuron development in FGR and control lambs.Results show that, in control lambs, total dendrite length and branching of CA1 hippocampal neurons significantly increased between newborn age and 4 weeks. In FGR lamb brains, neither dendrite length nor branching increased over this period, and dendrite deficits were worse in FGR lambs at 4 weeks, corresponding to reduced hippocampal area. In 4-week-old lambs, we observed a significant correlation between total dendrite length of CA1 neurons and memory function.Hippocampal growth trajectory and function deficits were corroborated in small-for-gestational-age (SGA) infants born very preterm. MRI was performed in very preterm infants in early life and repeated at term-equivalent age, showing that the trajectory of anterior hippocampal growth was significant

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