Preterm birth, socioeconomic status, and white matter development across childhood

Katie Mckinnon; Manuel Blesa Cábez; Melissa Thye; Selina Abel; Rebekah Smikle; Jean Skelton; Lorena Jiménez-Sánchez; Kadi Vaher; Gemma Sullivan; Amy Corrigan; Gayle Barclay; Charlotte Jardine; Iona Gerrish; Donna McIntyre; Yu Wei Chua; Ray Amir; Alan J Quigley; Cheryl Battersby; Athanasios Tsanas; G David Batty; Rebecca M Reynolds; Simon R Cox; Heather C Whalley; Michael J Thrippleton; Mark E Bastin; Hilary Richardson; James P Boardman

doi:10.1016/j.dcn.2025.101643

Preterm birth, socioeconomic status, and white matter development across childhood

Katie Mckinnon, Manuel Blesa Cábez, Melissa Thye, Selina Abel, Rebekah Smikle, Jean Skelton, Lorena Jiménez-Sánchez, Kadi Vaher, Gemma Sullivan, Amy Corrigan, Gayle Barclay, Charlotte Jardine, Iona Gerrish, Donna McIntyre, Yu Wei Chua, Ray Amir, Alan J Quigley, Cheryl Battersby, Athanasios Tsanas, G David BattyRebecca M Reynolds, Simon R Cox, Heather C Whalley, Michael J Thrippleton, Mark E Bastin, Hilary Richardson, James P Boardman^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Preterm birth and socioeconomic status (SES) are associated with brain development in early life, but the contribution of each over time is uncertain. We examined the effects of gestational age (GA) and SES on white matter microstructure in the neonatal period and at five years.

METHODS: Participants included preterm and term children. Diffusion MRI was collected at term-equivalent age (n=153 preterm, n=90 term [127/243 female]) and from a subset at five years (n=26 preterm, n=32 term [22/58 female]). We assessed linear associations of GA, SES (Scottish Index of Multiple Deprivation [SIMD] and maternal education), and GA×SES interactions on fractional anisotropy (FA) using tract-based spatial statistics. We compared the proportion of voxels with significant associations between timepoints.

RESULTS: In preterm neonates, higher GA and higher maternal education, but not SIMD, were associated with higher FA (p corrected for family-wise error rate, p FWER <0.05). GA-FA associations depended on maternal education and SIMD (β=|0.001-0.005|, p<0.001). At five years, the strength and direction of GA-FA associations depended on SIMD (β=|0.013-0.028|, p<0.001), but not maternal education. In term infants, lower SES was associated with higher FA at the neonatal timepoint only (p FWER <0.05).

CONCLUSIONS: Preterm birth and SES both shape brain development at birth and continue to do so at five years. The SES measure most strongly associated with FA in preterm infants switches from a family-level (i.e. maternal education) to neighborhood-level (i.e. SIMD) measure between birth and five years, which suggests strategies to mitigate adverse effects of social inequalities on development may require adaptation as children grow.

Original language	English
Article number	101643
Journal	Developmental Cognitive Neuroscience
Volume	77
Early online date	8 Nov 2025
DOIs	https://doi.org/10.1016/j.dcn.2025.101643
Publication status	Published - Jan 2026

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Preterm birth, SES, WM development across chi_James BoardmanAccepted author manuscript, 281 KB
Preterm birth, socioeconomic status, and white matter development across childhoodFinal published version, 5.59 MBLicence: Creative Commons: Attribution (CC-BY)

Preterm birth, Neurodevelopment and Cognition in Children: Causal Evidence and Mechanisms
Boardman, J. (Principal Investigator), Cox, S. (Co-investigator), Marioni, R. (Co-investigator), Reynolds, R. (Co-investigator), Richardson, H. (Co-investigator), Tsanas, T. (Co-investigator) & Whalley, H. (Co-investigator)
Medical Research Council
1/11/22 → 31/10/27
Project: Research

Cite this

Mckinnon, K., Blesa Cábez, M., Thye, M., Abel, S., Smikle, R., Skelton, J., Jiménez-Sánchez, L., Vaher, K., Sullivan, G., Corrigan, A., Barclay, G., Jardine, C., Gerrish, I., McIntyre, D., Chua, Y. W., Amir, R., Quigley, A. J., Battersby, C., Tsanas, A., ... Boardman, J. P. (2026). Preterm birth, socioeconomic status, and white matter development across childhood. Developmental Cognitive Neuroscience, 77, Article 101643. https://doi.org/10.1016/j.dcn.2025.101643

@article{a54593f355ac4e97b15c523b95515209,

title = "Preterm birth, socioeconomic status, and white matter development across childhood",

abstract = "BACKGROUND: Preterm birth and socioeconomic status (SES) are associated with brain development in early life, but the contribution of each over time is uncertain. We examined the effects of gestational age (GA) and SES on white matter microstructure in the neonatal period and at five years.METHODS: Participants included preterm and term children. Diffusion MRI was collected at term-equivalent age (n=153 preterm, n=90 term [127/243 female]) and from a subset at five years (n=26 preterm, n=32 term [22/58 female]). We assessed linear associations of GA, SES (Scottish Index of Multiple Deprivation [SIMD] and maternal education), and GA×SES interactions on fractional anisotropy (FA) using tract-based spatial statistics. We compared the proportion of voxels with significant associations between timepoints.RESULTS: In preterm neonates, higher GA and higher maternal education, but not SIMD, were associated with higher FA (p corrected for family-wise error rate, p FWER <0.05). GA-FA associations depended on maternal education and SIMD (β=|0.001-0.005|, p<0.001). At five years, the strength and direction of GA-FA associations depended on SIMD (β=|0.013-0.028|, p<0.001), but not maternal education. In term infants, lower SES was associated with higher FA at the neonatal timepoint only (p FWER <0.05).CONCLUSIONS: Preterm birth and SES both shape brain development at birth and continue to do so at five years. The SES measure most strongly associated with FA in preterm infants switches from a family-level (i.e. maternal education) to neighborhood-level (i.e. SIMD) measure between birth and five years, which suggests strategies to mitigate adverse effects of social inequalities on development may require adaptation as children grow.",

author = "Katie Mckinnon and \{Blesa C{\'a}bez\}, Manuel and Melissa Thye and Selina Abel and Rebekah Smikle and Jean Skelton and Lorena Jim{\'e}nez-S{\'a}nchez and Kadi Vaher and Gemma Sullivan and Amy Corrigan and Gayle Barclay and Charlotte Jardine and Iona Gerrish and Donna McIntyre and Chua, \{Yu Wei\} and Ray Amir and Quigley, \{Alan J\} and Cheryl Battersby and Athanasios Tsanas and Batty, \{G David\} and Reynolds, \{Rebecca M\} and Cox, \{Simon R\} and Whalley, \{Heather C\} and Thrippleton, \{Michael J\} and Bastin, \{Mark E\} and Hilary Richardson and Boardman, \{James P\}",

note = "CRediT author contributions KM: conceptualization, methodology, formal analysis, investigation, resources, data curation, writing (original draft), writing (review/editing), visualization. MBC: conceptualization, methodology, software, formal analysis, investigation, data curation, writing (review/editing), visualization. MT: conceptualization, methodology, software, formal analysis, investigation, data curation, writing (review/editing), visualization. SA: investigation, resources, writing (review/editing). RS: investigation, writing (review/editing). JS: investigation, writing (review/editing). LJS: investigation, resources, writing (review/editing). KV: formal analysis, investigation, writing (review/editing). GS: investigation, writing (review/editing). AC: data curation, project administration, writing (review/editing). GB: investigation, resources, writing (reviewing/editing). CJ: investigation, resources, writing (reviewing/editing). IG: investigation, resources, writing (reviewing/editing). DM: investigation, resources, writing (reviewing/editing). YWC: investigation, resources, data curation, writing (review/editing). RA: investigation, resources, data curation, writing (review/editing). AJQ: investigation, resources, writing (review/editing). CB: writing (review/editing), funding acquisition. AT: writing (review/editing), funding acquisition. GDB: writing (review/editing), funding acquisition. RMR: writing (review/editing), funding acquisition. SRC: methodology, writing (review/editing), funding acquisition. HCW: methodology, writing (review/editing), funding acquisition. MJT: methodology, resources, writing (review/editing). MEB: software, resources, writing (review/editing), funding acquisition. HR: conceptualization, methodology, formal analysis, resources, writing (original draft), writing (review/editing), visualization, supervision, project administration, funding acquisition. JPB: conceptualization, methodology, formal analysis, resources, writing (original draft), writing (review/editing), visualization, supervision, project administration, funding acquisition. ",

year = "2026",

month = jan,

doi = "10.1016/j.dcn.2025.101643",

language = "English",

volume = "77",

journal = "Developmental Cognitive Neuroscience",

issn = "1878-9293",

publisher = "Elsevier",

}

Mckinnon, K, Blesa Cábez, M, Thye, M, Abel, S, Smikle, R, Skelton, J, Jiménez-Sánchez, L, Vaher, K, Sullivan, G, Corrigan, A, Barclay, G, Jardine, C, Gerrish, I, McIntyre, D, Chua, YW, Amir, R, Quigley, AJ, Battersby, C, Tsanas, A, Batty, GD, Reynolds, RM , Cox, SR , Whalley, HC , Thrippleton, MJ , Bastin, ME , Richardson, H & Boardman, JP 2026, 'Preterm birth, socioeconomic status, and white matter development across childhood', Developmental Cognitive Neuroscience, vol. 77, 101643. https://doi.org/10.1016/j.dcn.2025.101643

TY - JOUR

T1 - Preterm birth, socioeconomic status, and white matter development across childhood

AU - Mckinnon, Katie

AU - Blesa Cábez, Manuel

AU - Thye, Melissa

AU - Abel, Selina

AU - Smikle, Rebekah

AU - Skelton, Jean

AU - Jiménez-Sánchez, Lorena

AU - Vaher, Kadi

AU - Sullivan, Gemma

AU - Corrigan, Amy

AU - Barclay, Gayle

AU - Jardine, Charlotte

AU - Gerrish, Iona

AU - McIntyre, Donna

AU - Chua, Yu Wei

AU - Amir, Ray

AU - Quigley, Alan J

AU - Battersby, Cheryl

AU - Tsanas, Athanasios

AU - Batty, G David

AU - Reynolds, Rebecca M

AU - Cox, Simon R

AU - Whalley, Heather C

AU - Thrippleton, Michael J

AU - Bastin, Mark E

AU - Richardson, Hilary

AU - Boardman, James P

N1 - CRediT author contributions KM: conceptualization, methodology, formal analysis, investigation, resources, data curation, writing (original draft), writing (review/editing), visualization. MBC: conceptualization, methodology, software, formal analysis, investigation, data curation, writing (review/editing), visualization. MT: conceptualization, methodology, software, formal analysis, investigation, data curation, writing (review/editing), visualization. SA: investigation, resources, writing (review/editing). RS: investigation, writing (review/editing). JS: investigation, writing (review/editing). LJS: investigation, resources, writing (review/editing). KV: formal analysis, investigation, writing (review/editing). GS: investigation, writing (review/editing). AC: data curation, project administration, writing (review/editing). GB: investigation, resources, writing (reviewing/editing). CJ: investigation, resources, writing (reviewing/editing). IG: investigation, resources, writing (reviewing/editing). DM: investigation, resources, writing (reviewing/editing). YWC: investigation, resources, data curation, writing (review/editing). RA: investigation, resources, data curation, writing (review/editing). AJQ: investigation, resources, writing (review/editing). CB: writing (review/editing), funding acquisition. AT: writing (review/editing), funding acquisition. GDB: writing (review/editing), funding acquisition. RMR: writing (review/editing), funding acquisition. SRC: methodology, writing (review/editing), funding acquisition. HCW: methodology, writing (review/editing), funding acquisition. MJT: methodology, resources, writing (review/editing). MEB: software, resources, writing (review/editing), funding acquisition. HR: conceptualization, methodology, formal analysis, resources, writing (original draft), writing (review/editing), visualization, supervision, project administration, funding acquisition. JPB: conceptualization, methodology, formal analysis, resources, writing (original draft), writing (review/editing), visualization, supervision, project administration, funding acquisition.

PY - 2026/1

Y1 - 2026/1

N2 - BACKGROUND: Preterm birth and socioeconomic status (SES) are associated with brain development in early life, but the contribution of each over time is uncertain. We examined the effects of gestational age (GA) and SES on white matter microstructure in the neonatal period and at five years.METHODS: Participants included preterm and term children. Diffusion MRI was collected at term-equivalent age (n=153 preterm, n=90 term [127/243 female]) and from a subset at five years (n=26 preterm, n=32 term [22/58 female]). We assessed linear associations of GA, SES (Scottish Index of Multiple Deprivation [SIMD] and maternal education), and GA×SES interactions on fractional anisotropy (FA) using tract-based spatial statistics. We compared the proportion of voxels with significant associations between timepoints.RESULTS: In preterm neonates, higher GA and higher maternal education, but not SIMD, were associated with higher FA (p corrected for family-wise error rate, p FWER <0.05). GA-FA associations depended on maternal education and SIMD (β=|0.001-0.005|, p<0.001). At five years, the strength and direction of GA-FA associations depended on SIMD (β=|0.013-0.028|, p<0.001), but not maternal education. In term infants, lower SES was associated with higher FA at the neonatal timepoint only (p FWER <0.05).CONCLUSIONS: Preterm birth and SES both shape brain development at birth and continue to do so at five years. The SES measure most strongly associated with FA in preterm infants switches from a family-level (i.e. maternal education) to neighborhood-level (i.e. SIMD) measure between birth and five years, which suggests strategies to mitigate adverse effects of social inequalities on development may require adaptation as children grow.

AB - BACKGROUND: Preterm birth and socioeconomic status (SES) are associated with brain development in early life, but the contribution of each over time is uncertain. We examined the effects of gestational age (GA) and SES on white matter microstructure in the neonatal period and at five years.METHODS: Participants included preterm and term children. Diffusion MRI was collected at term-equivalent age (n=153 preterm, n=90 term [127/243 female]) and from a subset at five years (n=26 preterm, n=32 term [22/58 female]). We assessed linear associations of GA, SES (Scottish Index of Multiple Deprivation [SIMD] and maternal education), and GA×SES interactions on fractional anisotropy (FA) using tract-based spatial statistics. We compared the proportion of voxels with significant associations between timepoints.RESULTS: In preterm neonates, higher GA and higher maternal education, but not SIMD, were associated with higher FA (p corrected for family-wise error rate, p FWER <0.05). GA-FA associations depended on maternal education and SIMD (β=|0.001-0.005|, p<0.001). At five years, the strength and direction of GA-FA associations depended on SIMD (β=|0.013-0.028|, p<0.001), but not maternal education. In term infants, lower SES was associated with higher FA at the neonatal timepoint only (p FWER <0.05).CONCLUSIONS: Preterm birth and SES both shape brain development at birth and continue to do so at five years. The SES measure most strongly associated with FA in preterm infants switches from a family-level (i.e. maternal education) to neighborhood-level (i.e. SIMD) measure between birth and five years, which suggests strategies to mitigate adverse effects of social inequalities on development may require adaptation as children grow.

U2 - 10.1016/j.dcn.2025.101643

DO - 10.1016/j.dcn.2025.101643

M3 - Article

C2 - 40585095

SN - 1878-9293

VL - 77

JO - Developmental Cognitive Neuroscience

JF - Developmental Cognitive Neuroscience

M1 - 101643

ER -

Preterm birth, socioeconomic status, and white matter development across childhood

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Preterm birth, Neurodevelopment and Cognition in Children: Causal Evidence and Mechanisms

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