Early brain injury in premature newborns detected with magnetic resonance imaging is associated with adverse early neurodevelopmental outcome.
OBJECTIVE
To determine the neurodevelopmental outcome of prematurely born newborns with magnetic resonance imaging (MRI) abnormalities.


METHODS
A total of 89 prematurely born newborns (median age 28 weeks postgestation) were studied with MRI when stable for transport to MRI (median age, 32 weeks postgestation); 50 newborns were studied again near term age (median age, 37 weeks). Neurodevelopmental outcome was determined at 18 months adjusted age (median) using the Mental Development Index (Bayley Scales Infant Development II) and a standardized neurologic exam.


RESULTS
Of 86 neonatal survivors, outcome was normal in 51 (59%), borderline in 22 (26%), and abnormal in 13 (15%). Moderate/severe MRI abnormalities were common on the first (37%) and second (32%) scans. Abnormal outcome was associated with increasing severity of white matter injury, ventriculomegaly, and intraventricular hemorrhage on MRI, as well as moderate/severe abnormalities on the first (relative risk [RR] = 5.6; P = .002) and second MRI studies (RR = 5.3; P = .03). Neuromotor abnormalities on neurologic examination near term age (RR = 6.5; P = .04) and postnatal infection (RR = 4.0; P = .01) also increased the risk for abnormal neurodevelopmental outcome.


CONCLUSIONS
In premature newborns, brain abnormalities are common on MRI early in life and are associated with adverse neurodevelopmental outcome.
Miller
Steven P
SP
Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA.
Ferriero
Donna M
DM
Leonard
Carol
C
Piecuch
Robert
R
Glidden
David V
DV
Partridge
J Colin
JC
Perez
Marta
M
Mukherjee
Pratik
P
Vigneron
Daniel B
DB
Barkovich
A James
AJ
D001930:Brain Injuries / Q000175:diagnosis* / Q000473:pathology; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000473:pathology; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology