Investigating Cerebral Anomalies in Preterm Infants and Associated Risk Factors With Magnetic Resonance Imaging at Term-Equivalent Age

Nicolas Elbaz ¹, Valérie Biran ², Chloé Ghozland ³

⁰Service d'Imagerie Pédiatrique, Hôpital Robert-Debré AP-HP, Université Paris-Cité, Paris, France.

Pediatric Neurology +

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December 9, 2025

View abstract on PubMed

Summary

Mechanical ventilation increases cerebral anomalies in preterm infants, while prolonged nutrition may protect white matter. Brain lesion severity and being small for gestational age also impact brain development.

Area Of Science

Neonatal neurology
Pediatric radiology
Neurodevelopmental disorders

Background

Preterm birth (<32 weeks gestation) is linked to cerebral anomalies and neurodevelopmental disorders.
Perinatal factors significantly influence the occurrence of these conditions.
Cerebral MRI at term-equivalent age (TEA) can elucidate these relationships.

Purpose Of The Study

To examine the association between perinatal factors, cerebral anomalies, and brain volumetry using MRI at TEA.
To identify specific risk and protective factors influencing brain development in preterm infants.

Main Methods

A cohort of 110 preterm infants (<32 weeks gestation) underwent cerebral MRI at TEA.
Cerebral anomalies were assessed using the Kidokoro scoring system.
Cerebral volumetry was performed to quantify brain volumes.
Relationships between 9 clinical factors, Kidokoro scores, and brain volumes were analyzed.

Main Results

Only 6% of preterm infants showed moderate-to-severe brain anomalies.
Mechanical ventilation was a risk factor for anomalies (aOR=4.6).
Prolonged parenteral nutrition was protective for white matter anomalies (aOR=0.2).
Mechanical ventilation and being small for gestational age were risk factors for reduced cerebral volumes.
Increased brain lesion severity correlated with decreased cerebral volumes.

Conclusions

Treatment-related perinatal factors significantly impact cerebral anomaly occurrence in preterm infants.
Both qualitative (Kidokoro scoring) and quantitative (volumetry) MRI are valuable tools for assessing preterm brain development.

Keywords:

Brain volumetry Kidokoro scoring Mechanical ventilation Parenteral nutrition

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