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Research ArticlePediatrics
Open Access

Postnatal Brain Growth Assessed by Sequential Cranial Ultrasonography in Infants Born <30 Weeks' Gestational Age

R. Cuzzilla, A.J. Spittle, K.J. Lee, S. Rogerson, F.M. Cowan, L.W. Doyle and J.L.Y. Cheong
American Journal of Neuroradiology June 2018, 39 (6) 1170-1176; DOI: https://doi.org/10.3174/ajnr.A5679
R. Cuzzilla
aFrom the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia
bDepartments of Obstetrics and Gynaecology (R.C., S.R., L.W.D., J.L.Y.C.)
eNeonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
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A.J. Spittle
aFrom the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia
dPhysiotherapy (A.J.S.), University of Melbourne, Melbourne, Australia
eNeonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
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K.J. Lee
aFrom the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia
cPaediatrics (K.J.L., L.W.D.)
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S. Rogerson
bDepartments of Obstetrics and Gynaecology (R.C., S.R., L.W.D., J.L.Y.C.)
eNeonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
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F.M. Cowan
fDepartment of Paediatrics (F.M.C.), Imperial College, London, UK.
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L.W. Doyle
aFrom the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia
bDepartments of Obstetrics and Gynaecology (R.C., S.R., L.W.D., J.L.Y.C.)
cPaediatrics (K.J.L., L.W.D.)
eNeonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
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J.L.Y. Cheong
aFrom the Victorian Infant Brain Studies research group (R.C., A.J.S., K.J.L., L.W.D., J.L.Y.C.), Murdoch Childrens Research Institute, Melbourne, Australia
bDepartments of Obstetrics and Gynaecology (R.C., S.R., L.W.D., J.L.Y.C.)
eNeonatal Services (R.C., A.J.S., S.R., L.W.D., J.L.Y.C.), The Royal Women's Hospital, Melbourne, Australia
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Abstract

BACKGROUND AND PURPOSE: Brain growth in the early postnatal period following preterm birth has not been well described. This study of infants born at <30 weeks' gestational age and without major brain injury aimed to accomplish the following: 1) assess the reproducibility of linear measures made from cranial ultrasonography, 2) evaluate brain growth using sequential cranial ultrasonography linear measures from birth to term-equivalent age, and 3) explore perinatal predictors of postnatal brain growth.

MATERIALS AND METHODS: Participants comprised 144 infants born at <30 weeks' gestational age at a single center between January 2011 and December 2013. Infants with major brain injury seen on cranial ultrasonography or congenital or chromosomal abnormalities were excluded. Brain tissue and fluid spaces were measured from cranial ultrasonography performed as part of routine clinical care. Brain growth was assessed in 3 time intervals: <7, 7–27, and >27 days' postnatal age. Data were analyzed using intraclass correlation coefficients and mixed-effects regression.

RESULTS: A total of 429 scans were assessed for 144 infants. Several linear measures showed excellent reproducibility. All measures of brain tissue increased with postnatal age, except for the biparietal diameter, which decreased within the first postnatal week and increased thereafter. Gestational age of ≥28 weeks at birth was associated with slower growth of the biparietal diameter and ventricular width compared with gestational age of <28 weeks. Postnatal corticosteroid administration was associated with slower growth of the corpus callosum length, transcerebellar diameter, and vermis height. Sepsis and necrotizing enterocolitis were associated with slower growth of the transcerebellar diameter.

CONCLUSIONS: Postnatal brain growth in infants born at <30 weeks' gestational age can be evaluated using sequential linear measures made from routine cranial ultrasonography and is associated with perinatal predictors of long-term development.

ABBREVIATIONS:

AHW
anterior horn width
BPD
biparietal diameter
BW
birth weight
CCL
corpus callosum length
cUS
cranial ultrasonography
GA
gestational age
NEC
necrotizing enterocolitis
PMA
postmenstrual age
PNA
postnatal age
TEA
term-equivalent age
TCD
transcerebellar diameter
  • © 2018 by American Journal of Neuroradiology

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American Journal of Neuroradiology: 39 (6)
American Journal of Neuroradiology
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1 Jun 2018
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Cite this article
R. Cuzzilla, A.J. Spittle, K.J. Lee, S. Rogerson, F.M. Cowan, L.W. Doyle, J.L.Y. Cheong
Postnatal Brain Growth Assessed by Sequential Cranial Ultrasonography in Infants Born <30 Weeks' Gestational Age
American Journal of Neuroradiology Jun 2018, 39 (6) 1170-1176; DOI: 10.3174/ajnr.A5679

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Postnatal Brain Growth Assessed by Sequential Cranial Ultrasonography in Infants Born <30 Weeks' Gestational Age
R. Cuzzilla, A.J. Spittle, K.J. Lee, S. Rogerson, F.M. Cowan, L.W. Doyle, J.L.Y. Cheong
American Journal of Neuroradiology Jun 2018, 39 (6) 1170-1176; DOI: 10.3174/ajnr.A5679
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