Brain MRI findings in near-term and term infants admitted to a neonatal ward

This study aimed to determine the incidence and patterns of abnormalities detected on brain magnetic resonance imaging (MRI) in near-term and term infants admitted to the neonatal ward.

A retrospective analysis was conducted of 714 near-term or term neonates (≥36 weeks' gestation) who were admitted to a tertiary neonatal ward between January 2023 and December 2023 and who underwent brain MRI scans.

Abnormal MRI findings were observed in 254 of 714 (35.6%) infants. The most common abnormalities were non-parenchymal hemorrhage, present in 162 of 714 (22.7%) infants, including subarachnoid hemorrhage (20.9%), cephalohematoma (11.2%), subdural hemorrhage (5.6%), extradural hemorrhage (5.6%), and intraventricular hemorrhage (2.8%), followed by brain parenchymal injury, present in 102 of 714 (14.3%) infants. Non-cerebral parenchymal hemorrhage and brain parenchymal injury were more frequently observed after vaginal deliveries and were associated with resuscitation with positive-pressure ventilation at birth and hypoxic-ischemic encephalopathy. Subependymal cysts were observed in 31 of 714 (4.3%) infants and were not associated with perinatal insults. Congenital variations or deformities were found in 8 of 714 (1.1%) infants.

Abnormal brain MRI findings were common in infants admitted to the neonatal ward after birth due to perinatal risk factors. The association between these MRI-defined cerebral injuries and long-term neurodevelopmental outcomes remains unclear and should be explored in long-term longitudinal studies using quantitative volumetric techniques to assess MRI-defined brain injuries and more sensitive instruments to address cognitive function.