Preterm birth: investigating the importance of sleep cycles on brain development

Around 60,000 babies are born prematurely in the UK each year.[1-2] While advances in treatment have led to improved survival, preterm babies have an increased risk of long-term neurodevelopmental complications. These vulnerable babies are cared for in an environment quite unlike that of the womb, which may affect their brain development. Professor Topun Austin of Cambridge University Hospitals NHS Foundation Trust is leading a study to look at the effect of natural sleep cycles on the developing brain. The results could ultimately have a major beneficial impact on how preterm babies are cared for in neonatal units, improving long-term neurodevelopmental outcomes.

How are children’s lives affected now?

Around one in every 13 babies in the UK is born too soon – before 37 weeks of pregnancy.^1,2 Although medical treatments are improving, preterm babies who survive have a higher risk of lifelong disabilities than those born full-term.

“The causes of neurodevelopmental complications in premature babies are complex and involve many factors,” says Professor Austin.

In the second half of pregnancy, a baby’s brain undergoes a period of rapid development, forming new connections and networks. At the same time, distinct sleep states emerge, with the baby cycling between so-called ‘active’ and ‘quiet’ periods of sleep. For babies born preterm and cared for in neonatal units, the frequent medical procedures, bright lights and loud noises may interrupt these natural sleep cycles essential for healthy brain development.

”This interruption of the natural cycling of sleep states could impact on the formation of important brain networks, and ultimately affect their neurodevelopmental outcomes,” says Professor Austin.

How could this research help?

“We aim to relate natural sleep cycles with the development of brain connections in preterm and full-term babies,” says Professor Austin.

Using a non-invasive imaging system consisting of a lightweight, flexible cap worn on the baby’s head, the team will study changes in blood flow in different parts of the brain which are the basis of the brain networks. In a previous pilot study, the researchers identified differences in blood flow and brain networks between distinct sleep states.

“We will then use sophisticated statistical techniques to look for differences in brain networks between active and quiet periods of sleep – and between preterm and full-term babies,” says Professor Austin.

The team will also collect information about the preterm babies’ environment that may interrupt their sleep cycles, such as background noise and routine care.

1. Office for National Statistics, Vital statistics in the UK: births, deaths and marriages - 2019 https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables [website accessed 08 February 2021]
2. National Institute for Health and Care Excellence, Preterm labour and birth final scope April 2013 http://www.nice.org.uk/guidance/gid-cgwave0660/resources/preterm-labour-and-birth-final-scope2

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