Neurodevelopmental Correlates of Brain MRI Abnormalities in Extremely-low-birth-weight Infants

To evaluate the relationship between impaired brain growth and structural brain abnormalities at term-equivalent age (TEA) and neurodevelopment in extremely-low-birthweight (ELBW) infants over the first 2 years. ELBW infants born from 2009 through 2018 and undergoing brain magnetic resonance imaging (MRI) at TEA were enrolled in this retrospective cohort study. MRI scans were reviewed using a validated quali-quantitative score, including several white and grey matter items. Neurodevelopment was assessed at 6, 12, 18, and 24 months using the Griffiths scales. The independent associations between MRI sub-scores and the trajectories of general and specific neurodevelopmental functions were analyzed by generalized estimating equations. One-hundred-nine ELBW infants were included. White matter volume reduction and delayed myelination were associated with worse general development (b -2.33, p=0.040; b -6.88, p=0.049 respectively), social skills (b -3.13, p=0.019; b -4.79, p=0.049), and eye-hand coordination (b -3.48, p=0.009; b -7.21, p=0.045). Cystic white matter lesions were associated with poorer motor outcomes (b -4.99, p=0.027), while white matter signal abnormalities and corpus callosum thinning were associated with worse non-verbal cognitive performances (b -6.42, p=0.010; b -6.72, p=0.021 respectively). Deep grey matter volume reduction correlated with worse developmental trajectories. Distinctive MRI abnormalities correlate with specific later developmental skills. This finding may suggest that TEA brain MRI may assist with neurodevelopmental prediction, counselling of families, and development of targeted supportive interventions to improve neurodevelopment in ELBW neonates.