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Updated: Dec 27, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Brain 3D-echographic early predictors of neuro-behavioral disorders in infants: a prospective observational study
Maria Cristina Aisa1,2,3, Antonella Barbati1, Sandro Gerli1,2,4
1Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.
Insights
Early 3D ultrasound brain measurements can predict neurodevelopmental risks in infants. Reduced regional brain volumes at 30-40 days indicate a higher risk of later neuro-behavioral disorders.
Area of Science:
- Neonatal neuroscience
- Medical imaging
- Developmental pediatrics
Background:
- Prematurity, low birth weight (LBW), very low birth weight (VLBW), and intrauterine growth restriction (IUGR) are established risk factors for adverse long-term neurodevelopmental outcomes.
- These conditions are associated with reduced regional brain volumes in infants.
Purpose of the Study:
- To investigate the utility of 3D ultrasound sonography (3DUS) for measuring regional brain volumes in neonates.
- To assess if these early volumetric measurements can predict the risk of neuro-behavioral disorders later in life.
Main Methods:
- A longitudinal study followed a selected cohort of full-term, preterm, IUGR, and preterm-IUGR infants from 30-40 days postnatal to 2 years of age.
- 3D ultrasound sonography (3DUS) was used to measure whole brain, thalamus, frontal cortex, and cerebellum volumes at 30-40 days.
- Neurodevelopment was assessed at 2 years using the Griffiths Mental Development Scales.
Main Results:
- Significantly reduced volumes of the whole brain, thalamus, frontal cortex, and cerebellum were observed in infants with negative neurodevelopmental outcomes.
- Receiver Operating Characteristic (ROC) curve analysis demonstrated strong diagnostic accuracy in differentiating between normal and abnormal neurodevelopmental groups.
Conclusions:
- 3DUS-derived regional brain volumes measured in early infancy show promise as early indicators for identifying neonates at high risk of neuro-behavioral disorders.
- Further large-scale studies are warranted to validate these findings and their clinical applicability.
Background:
Prematurity, low birth weight (LBW), very low birth weight (VLBW), and intrauterine growth restriction (IUGR) are risk factors of long-term poor neuro-development outcomes and associate with reduction of regional brain volumes.
Objective:
To evaluate the possible role of 3D ultrasound sonography (3DUS) regional brain volumes, measured at 30-40 days of postnatal period, as early predictors of long-term risk of neuro-behavioral disorders.
Methods:
A highly selected population, which included: full-term, preterm, IUGR, and preterm-IUGR born individuals, was followed longitudinally from 30 to 40 days of postnatal period to the second year of life. The population was mostly composed of bichorionic twins to ensure a, theoretically, major intracategory homogeneity. Preterm and IUGR subjects were characterized by a gestational age (GA) and birth weight (BW)>32 weeks and >1500 g, respectively, whereas the full-term neonates were of 37 weeks GA. At enrollment, the assessment of the volumetric measurements was performed using the 3DUS. The evaluation of neuro-development was performed at 2 years using the Griffiths Mental Development Scales.
Results:
The 3DUS measurements of whole brain, thalamus, frontal cortex, and cerebellum volumes, assessed at 30-40 days of postnatal period, were significantly reduced in infants characterized by negative outcome. In addition, the respective areas of the ROC curves, made by comparing values of normal and abnormal neuro-development groups, were indicative of a strong diagnostic accuracy.
Conclusion:
Data found suggest that the 3DUS regional brain volumes may assume a significant role as early indicators of neonates at major risk of neuro-behavioral disorders in later life. Further and larger studies in this direction are needed to validate this significant perspective.
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