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Updated: Jun 22, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Postnatal Brain Growth Assessed by Sequential Cranial Ultrasonography in Infants Born <30 Weeks' Gestational Age
R Cuzzilla1,2,3, A J Spittle4,5,3, K J Lee4,6
1From the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia rocco.cuzzilla@thewomens.org.au.
Insights
This study shows that routine cranial ultrasonography can track brain growth in preterm infants. Certain medical conditions and treatments in premature babies can impact their brain development.
Area of Science:
- Neonatal neurology
- Pediatric neuroimaging
- Developmental neuroscience
Background:
- Early postnatal brain growth in preterm infants (<30 weeks' gestational age) is not well-characterized.
- Understanding brain development in this vulnerable population is crucial for predicting long-term outcomes.
Purpose of the Study:
- To assess the reproducibility of linear measurements from cranial ultrasonography.
- To evaluate brain growth patterns from birth to term-equivalent age using serial ultrasonography.
- To identify perinatal factors associated with postnatal brain growth in preterm infants.
Main Methods:
- 144 infants born at <30 weeks' gestational age without major brain injury were included.
- Cranial ultrasonography was performed as part of routine clinical care.
- Intraclass correlation coefficients and mixed-effects regression were used for analysis.
Main Results:
- Linear measures from cranial ultrasonography demonstrated excellent reproducibility.
- Most brain tissue measures increased with postnatal age, with exceptions like the biparietal diameter.
- Gestational age at birth, postnatal corticosteroids, sepsis, and necrotizing enterocolitis were associated with altered brain growth trajectories.
Conclusions:
- Sequential linear measurements from routine cranial ultrasonography reliably assess postnatal brain growth in preterm infants.
- Perinatal factors significantly influence brain growth patterns in this population.
- These findings can inform monitoring and interventions for preterm infants.
Background And Purpose:
Brain growth in the early postnatal period following preterm birth has not been well described. This study of infants born at <30 weeks' gestational age and without major brain injury aimed to accomplish the following: 1) assess the reproducibility of linear measures made from cranial ultrasonography, 2) evaluate brain growth using sequential cranial ultrasonography linear measures from birth to term-equivalent age, and 3) explore perinatal predictors of postnatal brain growth.
Materials And Methods:
Participants comprised 144 infants born at <30 weeks' gestational age at a single center between January 2011 and December 2013. Infants with major brain injury seen on cranial ultrasonography or congenital or chromosomal abnormalities were excluded. Brain tissue and fluid spaces were measured from cranial ultrasonography performed as part of routine clinical care. Brain growth was assessed in 3 time intervals: <7, 7-27, and >27 days' postnatal age. Data were analyzed using intraclass correlation coefficients and mixed-effects regression.
Results:
A total of 429 scans were assessed for 144 infants. Several linear measures showed excellent reproducibility. All measures of brain tissue increased with postnatal age, except for the biparietal diameter, which decreased within the first postnatal week and increased thereafter. Gestational age of ≥28 weeks at birth was associated with slower growth of the biparietal diameter and ventricular width compared with gestational age of <28 weeks. Postnatal corticosteroid administration was associated with slower growth of the corpus callosum length, transcerebellar diameter, and vermis height. Sepsis and necrotizing enterocolitis were associated with slower growth of the transcerebellar diameter.
Conclusions:
Postnatal brain growth in infants born at <30 weeks' gestational age can be evaluated using sequential linear measures made from routine cranial ultrasonography and is associated with perinatal predictors of long-term development.
