Neurodevelopmental Outcome at 3 Years of Age in Very Low Birth Weight Infants According to Brain Development and Lesions

Mariya Malova; Alessandro Parodi; Mariasavina Severino; Domenico Tortora; Maria Grazia Calevo; Cristina Traggiai; Paolo Massirio; Diego Minghetti; Sara Uccella; Deborah Preiti; Lino Nobili; Andrea Rossi; Luca Antonio Ramenghi

doi:10.2174/1573396319666230208092416

Neurodevelopmental Outcome at 3 Years of Age in Very Low Birth Weight Infants According to Brain Development and Lesions

Curr Pediatr Rev. 2024;20(1):94-105. doi: 10.2174/1573396319666230208092416.

Authors

Mariya Malova¹, Alessandro Parodi¹, Mariasavina Severino², Domenico Tortora², Maria Grazia Calevo³, Cristina Traggiai¹, Paolo Massirio¹, Diego Minghetti¹, Sara Uccella^{4

5}, Deborah Preiti⁶, Lino Nobili^{4

5}, Andrea Rossi^{2

7}, Luca Antonio Ramenghi^{1

5}

Affiliations

¹ Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
² Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
³ Epidemiology and Biostatistics Unit, Scientific Direction, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
⁴ Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
⁵ Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
⁶ Psychology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
⁷ Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.

PMID: 36752291
DOI: 10.2174/1573396319666230208092416

Abstract

Background: During the last decades, severe brain lesions affecting very low birth weight (<1500 gr, VLBW) infants were gradually substituted by milder lesions with debatable prognoses.

Objective: The objective of this study is to define type, frequency and 3 years of neurodevelopmental outcome of prematurity-related brain lesions in a modern cohort of VLBW infants.

Methods: VLBW infants admitted to our NICU in 5 years period with brain MRI at term-equivalent age were included. MRI scans were reviewed to identify and grade white matter lesions (WML), intraventricular hemorrhage (IVH), and cerebellar hemorrhage (CBH). Linear measurements of brain size, biparietal width (BPW) and trans-cerebellar diameter (TCD) were carried out. Total maturation score (TMS) was calculated. Developmental Coefficients (DQ) on Griffiths Scale at 3 years of age were compared between patients with different types and grades of lesions and patients without lesions; possible correlations between linear brain measurements, brain maturation and outcome were explored.

Results: Study included 407 patients. Of them, 187 (46%) had at least one brain lesion on MRI, while 37 (9%) had severe lesions. The most frequent lesion was IVH (28%), followed by WML (21%) and CBH (17%). Mild and severe IVH, moderate and severe WML and all grades of CBH were related to worst outcome at 3 years. In patients without lesions, small BPW and small TCD were associated with worse outcomes. No correlations were observed between TMS and outcome.

Conclusion: We have observed that even mild brain lesions have a negative influence on neurological outcome at 3 years of age.

Keywords: Very low birth weight infants; brain growth; cerebellar hemorrhage; intraventricular hemorrhage; neurodevelopmental outcome; preterm infants; total maturation score; white matter lesions.