Dose Brain MRI before Discharge at NICU Predict Neurodevelopmental Outcomes in Very Low Birth Weight Infants?

Purpose: To test whether brain MRI can predict neurodevelopmental outcomes of very low birth weight (VLBW) infants in a single academic center. Methods: This was a retrospective study of VLBW infants admitted to neonatal intensive care unit from January 2010 to December 2014. Infants who were taken brain MRI before discharge and followed-up at 12 or 24 months` corrected age (CA) were enrolled. The neurodevelopment outcomes included cerebral palsy (CP) and cognitive or motor delay on Bayley Scale of Infant Development-II. Results: Of the 255 survivors at discharge, 182 (71.4%) had a brain MRI. Any abnormalities on brain MRI were predictive of CP (odds ratio [OR] 15.8, 95% confidence interval [CI] 1.9-128.1) and motor delay(OR 4.4, 95% CI 1.0-19.3) at 12 months` CA. Moderate to severe white matter abnormalities on brain MRI were significantly correlated with CP (OR 49.0, 95% CI 10.1-238.2) and moderate to severe motor delay (OR 8.3, 95% CI 1.2-56.7) at 12 months` CA, and CP (OR 43.8, 95% CI 6.4-299.8) at 24 months` CA. Moderate to severe white matter abnormalities on brain MRI were consistently associated with CP at 12 and 24 months` CA after adjustment for demographic and clinical variables and cranial ultrasonography findings (OR 800.5, 95% CI 6.9-92,665.7 at 12 months` CA, OR 52.0, 95% CI 1.3-2,168.2 at 24 months` CA). Conclusion: Moderate to severe white matter abnormalities on brain MRI strongly predicted cerebral palsy at 12 months and 24 months` CA in VLBW infants.