Neonatal MRI: Highly Predictive of Neurodevelopmental Outcomes

Moderate-to-severe white-matter abnormalities predicted adverse neurodevelopmental outcomes at age 2.

Predicting neurodevelopmental outcomes of premature infants is important for parents and may help in the development of more precise interventions. In this prospective study, 167 preterm infants (gestational age at birth, ≤30 weeks) underwent magnetic resonance imaging (MRI) at the gestational age of 40 weeks and were followed until 2 years of age.

Increasing severity of cerebral white-matter abnormalities was significantly related to cognitive and psychomotor delay, cerebral palsy, and neurosensory impairment at age 2 years. For example, infants with no white-matter disease had significantly higher Mental Development Index scores compared with infants with severe white-matter abnormalities (mean scores, 92 vs. 70). Sixty-seven percent of infants with severe white-matter disease had cerebral palsy versus 2% of those with no abnormalities.

Comment: Should all very premature infants undergo MRIs before discharge? Editorialists indicate that it is too soon to use these study results to advocate for routine use of MRI. Rather, given the uncertainty of predicting neurodevelopmental outcome, they believe in the advice: "Take them home, give them lots of love, and let’s see how things go." I tend to agree, until we are more certain about which findings predict which outcomes.

— Howard Bauchner, MD

Published in Journal Watch Pediatrics and Adolescent Medicine September 13, 2006

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