Three-dimensional ultrasound cranial imaging and early neurodevelopment in preterm growth-restricted infants

Aim: Fetal growth restriction (FGR) is associated with increased perinatal morbidity, mortality and long-term neurodevelopmental sequelae. The objective of this study was to examine whether information about early neurodevelopmental deficits was evident using three-dimensional head ultrasound and developmental assessments in preterm infants with FGR, compared with appropriate for gestational age (AGA) infants in the early post-natal period. Methods: Twenty preterm FGR infants weighing <10th centile and born between 28 and 32 weeks were compared with age-matched AGA infants. In the second post-natal week after birth, we used three-dimensional ultrasound to assess cerebral ventricular volumes. Prechtl General Movement Assessments were performed at 4–6 weeks after birth. Test of Infant Motor Performance (TIMP) to measure functional motor behaviour was performed at 4–6 and 12–14 weeks corrected age. Results: There was no statistically significant difference in the combined cerebral ventricular volume between the two groups (FGR, 0.81 ± 0.42 vs. AGA 0.72 ± 0.38 cm³, P = 0.4). The TIMP assessment at 12–14 week term corrected demonstrated lower scores (worse performance) in FGR infants compared with the AGA cohort (regression coefficient: −7.74 (95% CI −16.06, 0.57); P = 0.07). We observed a significant correlation between greater ventricular volume and lower TIMP scores in the cohorts separately and also overall (FGR, r = −0.5, P = 0.06 vs. AGA, r = −0.62, P = 0.007 and overall, r = −0.53, P = 0.001). Conclusion: Ultrasound in the early weeks may be useful to detect the neuropathology which could then mediate functional consequences.