Table 1_The relationship between sonographically assessed volumetric brain development in VLBW preterm infants and neurodevelopmental outcome at 2 years of age—data from the NeoNEVS project.docx

BackgroundVery low birth weight (VLBW) preterm infants are at increased risk for long-term neurodevelopmental impairment. Early identification of infants at risk remains challenging, particularly with regard to dynamic brain development during neonatal intensive care. Cranial ultrasound (CUS) allows safe and repeated bedside assessment of cerebral growth over time.
MethodsIn this retrospective cohort study, 79 VLBW infants (<1,500 g, <32 weeks gestation) treated at two tertiary neonatal intensive care units between 2019 and 2021 were included. Serial cranial ultrasound examinations were performed from birth to discharge. Total brain volume was estimated using a validated ellipsoid model, and individual cerebral growth rates were derived from longitudinal measurements. Neurodevelopmental outcome at 24 months corrected age was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), reporting percentile ranks for cognitive, language, motor, and a combined developmental score. Associations were evaluated using Spearman correlation and multivariable linear regression.
ResultsThe median cerebral brain growth rate was 2.4 cm3/day (95% CI: 1.5–3.1). Cerebral growth rate demonstrated a modest but statistically significant positive correlation with Bayley-III motor percentile rank (r = 0.25, p < 0.05). Associations with cognitive, language, and combined Bayley outcomes were positive but did not reach statistical significance. Total brain volume at discharge was not associated with neurodevelopmental outcomes in any domain. Cerebral growth rate was modestly correlated with the decline in head circumference percentile from birth to discharge. Conclusion: Longitudinal ultrasound-derived cerebral brain growth is associated with motor development at two years corrected age in VLBW infants, whereas single time-point brain volume measurements are not. Serial cranial ultrasound represents a feasible bedside approach to complement clinical risk assessment and may contribute to early neurodevelopmental risk stratification.

研究背景：极低出生体重（VLBW）早产儿长期神经发育障碍的发病风险显著升高。对这类高危患儿进行早期识别仍存在挑战，尤其是在新生儿重症监护期间，患儿脑发育处于动态变化过程中。颅脑超声（CUS）可安全且反复地在床旁评估随时间推移的脑发育情况。
研究方法：本回顾性队列研究纳入了2019年至2021年间，在两家三级新生儿重症监护病房接受诊疗的79名出生体重<1500g、胎龄<32周的VLBW早产儿。所有受试者均接受了从出生至出院的系列颅脑超声检查。采用经过验证的椭球体模型估算总脑体积，并从纵向测量数据中推导得到个体脑生长速率。以贝利婴幼儿发育量表第三版（Bayley-III）评估受试者校正胎龄24个月时的神经发育结局，报告认知、语言、运动及综合发育评分的百分位秩。采用斯皮尔曼相关分析与多变量线性回归对变量间的关联进行评估。
研究结果：脑生长速率的中位数为2.4cm³/天（95%置信区间：1.5~3.1）。脑生长速率与Bayley-III运动评分百分位秩呈轻度但具有统计学意义的正相关（r=0.25，p<0.05）；与认知、语言及综合发育结局的关联均为正向，但未达到统计学显著性水平。出院时的总脑体积与各神经发育维度结局均无关联。脑生长速率与出生至出院期间头围百分位的下降幅度呈轻度相关。
结论：VLBW早产儿的系列超声衍生脑生长速率与校正胎龄2岁时的运动发育存在关联，而单时间点的脑体积测量则无此关联。系列颅脑超声是一种可行的床旁评估手段，可辅助临床风险评估，或有助于实现早期神经发育风险分层。