Article Text
Abstract
Objective To explore relationships of early postnatal cranial ultrasonography (cUS) linear measures of brain size and brain growth with neurodevelopment at 2 years in infants born <30 weeks’ gestational age (GA) and free of major brain injury.
Design Prospective observational cohort study.
Setting Tertiary neonatal intensive care unit.
Patients 139 infants born <30 weeks’ GA, free of major brain injury on neonatal cUS and without congenital or chromosomal anomalies known to affect neurodevelopment.
Intervention Linear measures of brain tissue and fluid spaces made from cUS at 1-week, 1-month and 2-months’ postnatal age.
Main outcome measures Cognitive, language and motor scores on the Bayley Scales of Infant and Toddler Development, third edition at 2 years’ corrected age.
Results 313 scans were evaluated from the 131 children who were assessed at 2 years. Larger measures of the corpus callosum at 1 week, 1 month and 2 months, cerebellum and vermis at 2 months and faster positive growth of the cerebellum and vermis between 1 month and 2 months, were related to higher cognitive and language scores at 2 years. No relation between tissue measures and motor scores was found. Larger measures, and faster rate of increase, of fluid spaces within the first weeks after birth were related to better cognitive, language and motor outcomes at 2 years.
Conclusions Early postnatal cUS linear measures of brain tissue were related to cognitive and language development at 2 years in infants born <30 weeks’ GA without major brain injury. Relationships between cUS linear measures of fluid spaces in the early postnatal period and later neurodevelopment warrant further exploration.
- neonatology
- neurology
Data availability statement
Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Data are securely stored in keeping with National Health and Medical Research Council (Australia) requirements.
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Data availability statement
Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Data are securely stored in keeping with National Health and Medical Research Council (Australia) requirements.
Footnotes
Contributors RC is responsible for the overall content of the current study (guarantor), conceptualised and designed the study, collected the additional data, conducted the data analyses, drafted the initial manuscript and reviewed and revised the manuscript; FMC, LWD, JLYC and AS conceptualised and designed the study, contributed to data analyses and critically reviewed the manuscript; SR and PJA contributed to interpretation of data and critical revisions of the manuscript.
Funding Supported by grants from the National Health and Medical Research Council of Australia (Centre of Research Excellence #1060733, including PhD stipend to RC; Career Development Fellowship #1108714 to AS; Project grant #1101035; Investigator Grant #1176077 to PJA), the Medical Research Future Fund of Australia (Career Development Fellowship to JLYC #1141354) and the Victorian Government’s Operational Infrastructure Support Program.
Provenance and peer review Not commissioned; externally peer reviewed.
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