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Updated: Jul 7, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Improving head growth in preterm infants--a randomised controlled trial II: MRI and developmental outcomes in the
1Professor R W I Cooke, Neonatal Unit, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK; mc19@liv.ac.uk.
Insights
Addressing early energy deficits in very preterm infants may enhance brain growth and improve neurodevelopmental outcomes. Quantitative MRI shows promise in predicting developmental trajectories in these vulnerable infants.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Neuroimaging
Background:
- Very preterm infants face risks of poor growth and neurodevelopmental issues.
- Undernutrition is common in the early weeks due to feeding challenges.
- Early nutrition and brain development are critical for long-term outcomes.
Purpose of the Study:
- To investigate the link between early nutrition, head growth, MRI, and developmental outcomes in infants born before 29 weeks' gestation.
- To assess the impact of different feeding regimens on infant development.
- To explore the predictive value of quantitative MRI for neurodevelopment.
Main Methods:
- Randomized trial of hyperalimented versus standard feeding regimens up to 34 weeks' postmenstrual age (PMA).
- Primary outcome: occipitofrontal circumference (OFC) at 36 weeks' PMA.
- Secondary assessments: quantitative MRI at 40 weeks' PMA and Bayley Scales of Infant Development II (BSID II) at 3 and 9 months post-term.
Main Results:
- No significant differences in MRI findings, mental development index (MDI), or psychomotor development index (PDI) between feeding groups.
- Significant correlation found between energy deficit at 28 days and total brain volume (TBV) at 40 weeks' PMA, MDI, and PDI at 3 months post-term.
- 109 infants survived to 1 year; MRI and developmental assessments were completed on subsets of survivors.
Conclusions:
- Reducing early energy deficits in very preterm infants may support brain growth.
- Quantitative MRI can potentially predict developmental outcomes.
- Post-natal head growth and MRI findings are closely associated with mental development in the first year.
Background:
Very preterm infants are at risk of poor growth and neurodevelopmental outcome. Illness and difficulties overcoming the challenges of feeding these infants often lead to undernutrition in the first few weeks.
Objective:
To explore the relationships between early nutrition, post-natal head growth, quantitative magnetic resonance imaging (MRI) and developmental outcome in the first year among infants born before 29 weeks' gestation.
Design:
Infants born before 29 weeks' gestation were randomised to receive hyperalimented or standard feeding regimen from birth to 34 weeks' postmenstrual age (PMA). The primary outcome was occipitofrontal circumference (OFC) at 36 weeks' OFC. Quantitative MRI was performed at 40 weeks' PMA. Developmental assessment using Bayley Scales of Infant Development II (BSID II) was carried out at 3 and 9 months post-term.
Results:
109 infants survived to the end of the first year PMA. 65 infants underwent MRI scan. 81 and 71 infants were seen at 3 and 9 months post-term. Quantitative MRI findings, mental development index (MDI) and psychomotor development index (PDI) were not statistically different between the two groups. Total brain volume (TBV) at 40 weeks' PMA, MDI and PDI at 3 months post-term correlated significantly with energy deficit at 28 days of age
Conclusions:
Improving early energy deficit in very preterm infants may promote brain growth. Quantitative MRI may have a role to play in predicting developmental outcome. Post-natal growth at 36 weeks' PMA and quantitative MRI finding at 40 weeks' PMA appear to be closely related to mental outcomes in the first year.
Trial Registration Number:
ISRCTN 19509258.
