Sonographic Brain Volume Growth Trajectories in VLBW and Clinical Determinants-Data from the NeoNEVS Project

Very Low Birth Weight preterm infants are at elevated risk for disrupted brain growth and later neurodevelopmental impairment. Bedside-accessible tools for monitoring cerebral development remain limited.

In this retrospective pilot cohort study, 153 Very Low Birth Weight infants (<32 weeks gestational age and/or <1500 g) from two Level III Neonatal Intensive Care Units underwent serial cranial ultrasound assessments. Total brain volume was estimated using an ellipsoid formula derived from standardized imaging planes. Growth trajectories were analysed via linear mixed-effects modelling. Associations with clinical predictors-including invasive ventilation, sepsis, and somatic growth-were evaluated.

A total of 976 brain volume measurements were collected. Median cerebral volume increased from 164 cm³ to 275 cm³ across the hospital stay, corresponding to a median growth rate of 2.3 cm³/day (95% CI: 1.5-3.1). Duration of invasive mechanical ventilation was associated with reduced cerebral growth (p < 0.01, R² = 0.26). Cerebral volume growth showed a weak but statistically significant correlation with head circumference percentile progression (p < 0.05, ρ = 0.16).

Sonographic brain volumetry is a feasible and non-invasive method for tracking cerebral development in Very Low Birth Weight infants. These findings confirm significant associations between cerebral growth and head growth and identify prolonged invasive ventilation as a risk factor for impaired cerebral development.