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Early Ultrasonic Monitoring of Brain Growth and Later Neurodevelopmental Outcome in Very Preterm Infants
V A A Beunders1, J A Roelants1, J Suurland2
1From the Department of Pediatrics (V.A.A.B., J.A.R., P.G., R.M.C.S., I.K.M.R., M.J.V.).
Insights
Early cranial ultrasound markers, corpus callosum-fastigium and corpus callosum length, predict neurodevelopment in very preterm infants. Corpus callosum length offers added clinical utility for predicting outcomes in infants without brain injury.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Medical imaging
Background:
- Early brain growth monitoring in very preterm infants can predict later neurodevelopmental outcomes.
- Cranial ultrasound markers may offer insights into neurodevelopmental trajectories.
Purpose of the Study:
- To investigate associations between early cranial ultrasound markers (corpus callosum-fastigium and corpus callosum length) and neurodevelopmental outcomes in very preterm infants.
- To assess the added value of these markers in predicting neurodevelopmental outcomes when combined with neonatal risk factors and head circumference.
Main Methods:
- Prospective observational study of 225 infants born at <30 weeks' gestational age.
- Cranial ultrasound measurements (corpus callosum-fastigium and corpus callosum length) and head circumference were taken at multiple time points.
- Neurodevelopmental outcomes (cognitive, motor, language, behavioral) were assessed at 2 years' corrected age in infants without brain injury.
Main Results:
- Greater corpus callosum-fastigium length at 2 months correlated with better cognitive outcomes in infants without brain injury.
- Corpus callosum length at 2 months was positively associated with cognitive, motor, and language outcomes.
- Faster corpus callosum length growth between birth and 2 months predicted better cognitive and motor function; prediction models improved with added corpus callosum length.
Conclusions:
- Both corpus callosum-fastigium and corpus callosum length are associated with neurodevelopmental outcomes in very preterm infants without brain injury.
- Corpus callosum length demonstrates added clinical utility for predicting neurodevelopmental outcomes in this population.
Background And Purpose:
In infants born very preterm, monitoring of early brain growth could contribute to prediction of later neurodevelopment. Therefore, our aim was to investigate associations between 2 early cranial ultrasound markers (corpus callosum-fastigium and corpus callosum length) and neurodevelopmental outcome and the added value of both markers in the prediction of neurodevelopmental outcome based on neonatal risk factors and head circumference in very preterm infants.
Materials And Methods:
This prospective observational study included 225 infants born at <30 weeks' gestational age, of whom 153 were without any brain injury on cranial ultrasound. Corpus callosum-fastigium and corpus callosum length and head circumference were measured at birth, 29 weeks' gestational age, transfer from the neonatal intensive care unit to a level II hospital, and 2 months' corrected age. We analyzed associations of brain markers and their growth with cognitive, motor, language, and behavioral outcome at 2 years' corrected age.
Results:
In infants without brain injury, greater corpus callosum-fastigium length at 2 months was associated with better cognitive outcome. Corpus callosum length at 2 months was positively associated with cognitive, motor, and language outcome. Faster growth of the corpus callosum length between birth and 2 months was associated with better cognitive and motor function. Prediction of neurodevelopmental outcome based on neonatal risk factors with or without head circumference was significantly improved by adding corpus callosum length.
Conclusions:
Both corpus callosum-fastigium and corpus callosum length on cranial ultrasound are associated with neurodevelopmental outcome of very preterm infants without brain injury at 2 years, but only corpus callosum length shows the added clinical utility in predicting neurodevelopmental outcome.
