A systematic review of pre- and postnatal ultrasound measurements for assessing brain growth: Reliability and implications for clinical practice
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Published on: February 2, 2015
Mathies Rondagh1, Bregje O van Oldenmark1, Phebe J Adama van Scheltema2
1Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, the Netherlands.
Insights
This review found that pre- and postnatal ultrasound measurements reliably assess early brain growth. A standardized set of measurements is proposed to monitor infant brain development and identify potential risks.
Area of Science:
- Neuroimaging
- Pediatric Ultrasound
- Developmental Biology
Background:
- Early brain growth is crucial for neurodevelopment.
- Ultrasound is a non-invasive tool for fetal and infant assessment.
- Reliable methods are needed to track longitudinal brain development.
Purpose of the Study:
- To systematically review and assess the reliability of pre- and postnatal ultrasound measurements for early longitudinal brain growth evaluation.
- To propose a feasible set of ultrasound measurements for clinical practice and research.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Quality assessment using the QAREL scale for risk of bias.
- Inclusion of studies reporting intraclass correlation coefficients (ICCs) for intra- and interobserver agreement.
Main Results:
- Twenty-two studies were included, focusing on prenatal (11) and postnatal (10) measurements.
- Twenty-seven prenatal and thirty-two postnatal measurements were analyzed.
- Predominantly good to excellent intra- and interobserver reliability was reported for ultrasound measurements.
Conclusions:
- A gap exists in studies assessing longitudinal brain growth from prenatal to postnatal periods.
- Collaboration among specialists is vital for monitoring infant brain growth.
- A proposed set of ultrasound measurements can aid in identifying infants at risk for abnormal brain development.
Background And Aim:
The aim of this systematic review was to identify and assess the reliability of pre- and postnatal ultrasound measurements for evaluating early longitudinal brain growth. The secondary aim was to provide a reliable and feasible set of pre- and postnatal ultrasound measurements for clinical practice and future research.
Methods:
This review was conducted according to PRISMA guidelines and used the validated QAREL scale to assess the risk of bias in the included studies. We included studies assessing the reliability of prenatal and/or postnatal ultrasound measurements. Articles were excluded if intraclass correlation coefficients for intra- or interobserver agreement were not provided. The primary outcome was the intraclass correlation coefficient (ICC) of the intra- and inter-observer agreement.
Results:
A total of twenty-two studies were included, in which one study assessed both pre- and postnatal brain growth measurements, eleven studies focused on prenatal measurements, and ten on postnatal measurements. In these studies, twenty-seven prenatal and thirty-two postnatal ultrasound measurements were used to assess brain growth, showing predominantly good or excellent intra- and interobserver reliability.
Conclusions:
This review highlighted a significant gap in studies assessing longitudinal brain growth from the pre- to the postnatal period. Therefore, collaboration between obstetricians, radiologists and neonatologists is important for assessing longitudinal brain growth, which could help identify infants at risk of abnormal brain growth and potential neurodevelopmental impairment. We propose a set of ultrasound measurements of total brain size, ventricles, cerebellum, and corpus callosum to monitor early brain growth.
