Reference Values for Liver Stiffness in Newborns by Gestational Age, Sex, and Weight Using Three Different
Ángel Lancharro Zapata1,2, Alejandra Aguado Del Hoyo1,2, María Del Carmen Sánchez Gómez de Orgaz2,3,4
1Diagnostic Imaging Department, Paediatric Radiology Section, Gregorio Marañón General University Hospital, 28009 Madrid, Spain.
Journal of Clinical Medicine
|August 14, 2025
Summary
Neonatal liver stiffness in healthy newborns inversely correlates with gestational age, as measured by point shear wave elastography (pSWE) and 2D shear wave elastography (2D-SWE). These safe and reliable techniques establish crucial reference values for early hepatic assessment.
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Medical Imaging and Ultrasound
- Neonatology
Background:
- Establishing reference values for neonatal liver stiffness is essential for accurate clinical assessment.
- Existing data on liver stiffness in healthy neonates, particularly across different gestational ages, is limited.
- Elastography techniques offer non-invasive methods for evaluating liver tissue properties.
Purpose of the Study:
- To determine reference values for liver stiffness in healthy newborns during the first week of life.
- To assess the influence of gestational age, sex, and birth weight on neonatal liver stiffness.
- To compare the efficacy of point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) using convex and linear probes.
Main Methods:
- A cross-sectional observational study included 287 healthy newborns (24-42 weeks gestation).
- Liver stiffness was measured using pSWE and 2D-SWE (convex and linear probes) within the first week of life.
- Statistical analysis, including linear regression, identified associations between liver stiffness and neonatal variables (p < 0.05).
Main Results:
- Valid measurements were obtained from 208 (pSWE), 224 (2D-SWE convex), and 222 (2D-SWE linear) neonates.
- A significant inverse association was found between liver stiffness and gestational age across most techniques (p < 0.03).
- 2D-SWE with a convex probe showed a significant association with birth weight and had shorter examination times than pSWE (p < 0.001).
Conclusions:
- Neonatal liver stiffness, measured by pSWE and 2D-SWE (convex probe), inversely correlates with gestational age, indicating liver maturation.
- These elastography techniques are safe, reliable, and valuable for differentiating normal findings from early hepatic pathology in neonates.
- The study provides essential reference values for clinical hepatic assessment in the neonatal period.
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