White matter injury (WMI) is a major cause of neurodevelopmental impairment (NDI) in extremely preterm infants, with ventriculomegaly (VM) and impaired corpus callosum (CC) growth proposed as early indicators of diffuse WMI. This study evaluated whether early cranial ultrasound (cUS) markers are associated with later NDI. This retrospective study included infants born <28 weeks’ gestation and admitted to a tertiary NICU between 2019 and 2020 who completed serial cUS and neurodevelopmental assessments at 18-24 months of corrected age. Those with major brain lesions, severe intraventricular hemorrhage, or congenital anomalies were excluded. cUS measured CC thickness, length, and ventricular width from birth to term-equivalent age (TEA). Clinical characteristics and cUS findings were compared between infants with and without NDI. Among 70 extremely preterm infants (mean GA 25.7 weeks; BW 827 g), 20 developed NDI. Perinatal factors or comorbidities were similar between groups. Isolated VM at TEA was more frequent in the NDI group (15% vs. 6%), though not statistically significant (p = 0.224). The NDI group had significantly thinner CC at TEA (1.6 mm vs. 1.8 mm, p = 0.026) and slower CC thickness growth rate before TEA (0.01 mm/week vs. 0.02 mm/week, p = 0.019), with no difference in CC length or its progression. Serial cUS markers, particularly reduced CC thickness and slower CC growth velocity, were associated with later NDI. Higher but underpowered incidence of isolated VM was observed, supporting the role of serial cUS in early risk stratification over standalone prediction.
Wu et al. (Sun,) studied this question.
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