Universal Cranial Ultrasound Screening in Preterm Infants With Gestational Age 33-36 Weeks. A Retrospective Analysis of 724 Newborns

Late preterm births: New insights from neonatal neuroimaging and neurobehaviour

“…Predictors of "unfavourable" scans included lower gestational age, Apgar score < 5 at 5 min and presence of comorbidities such as respiratory distress and hypoxic-ischaemic encephalopathy. Another single centre study of 724 infants born between 33 and 36 weeks reported cranial ultrasound abnormalities in 13% of the cohort, with the highest rates in those born most preterm (27.1% in 33 week infants compared with 3.7% in 36 week infants) [13]. The abnormalities included intraventricular haemorrhages, periventricular leukomalacia, cysts, or venous thrombosis.…”

“…The abnormalities included intraventricular haemorrhages, periventricular leukomalacia, cysts, or venous thrombosis. The study identified several perinatal associations with abnormal cranial ultrasound, including a head circumference measurement of < 3rd centile, ventilation or surfactant at birth, an Apgar score ≤6 at 5 min, and abnormal neurological examination in the neonatal period [13]. The higher rates in the second study likely reflect inclusion of more preterm babies compared with the first study.…”

Identification of risk factors in infants participating in a Follow-up program

“…The same study found a low rate (28%) of high-risk newborns who were exclusively breastfed, although these infants would be more likely to benefit from exclusive breastfeeding 29 . Another study found that receiving breast milk after discharge resulted in better scores on the Bayley Child Development Scale (Bayley-III) in both genders, emphasizing the importance of breastfeeding for infant development 24 .…”

“…US is a convenient and useful method to detect intracranial lesions in at-risk NBs. In one study, infants born at 33-34 weeks who required mechanical ventilation or surfactant use, had low Apgar scores at five minutes, or neurological abnormalities were more likely to have abnormal cranial ultrasounds 29 .…”

Routine Neuroimaging of the Preterm Brain

“…The presence of risk factors such as abnormal neurologic examination, intrauterine growth restriction, abnormal head circumference, low Apgar scores, and need for ventilation or surfactant increased the chance of detecting an abnormality by fourfold in a group of more mature preterm infants born at 33 to 36 weeks' gestational age. 17 In a similar study, infants born at .30 weeks' gestation who were found to have significant ultrasonographic abnormalities typically had clinically significant events, such as placental abruption, seizures, hypotension, and hydrocephalus, which warranted the cranial ultrasonographic investigations. 18 Risk factors also play a role in the more immature preterm infants as well.…”