MRI scoring systems in neonatal encephalopathy and neurodevelopmental outcomes: a systematic review

Neonatal brain MRI is standard of care for neuroimaging in infants with neonatal encephalopathy (NE); no international consensus exists on scoring systems to predict neurodevelopmental outcomes. This systematic review evaluates the predictive performance of existing neonatal MRI scoring systems for NE. Cochrane and PRISMA guidelines were adhered to and the study was registered with PROSPERO. Key outcomes included MRI scoring correlation in infants born at ≥36 weeks with neurodevelopmental outcomes. Of 1525 studies retrieved, and 16 met the inclusion criteria, totalling 1925 participants with follow-up data. Scoring systems evaluated included NICHD, Rutherford, Weeke, Trivedi, Barkovich, and one newly developed score. Fifteen studies found an association with outcomes; one found no correlation with IQ or typical development. All MRI scoring systems have similar predictive accuracy. Simpler systems, such as NICHD, performed on par with more complex counterparts, suggesting they may offer a more efficient option in clinical settings.