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Background <p>White matter injury is a leading cause of neurodevelopmental impairment in premature infants. Timely initiation of novel therapies in clinical development will require early identification of clinically significant white matter injury. Head ultrasound is commonly obtained at 7 days and 30&#xa0;days of life (DOL) to screen for brain injuries in premature infants.</p> Objective <p>To determine if white matter injury severity on head ultrasound at 7 DOL and 30 DOL is associated with white matter injury severity on term-equivalent age MRI and with neurological outcomes through age 2&#xa0;years.</p> Materials and methods <p>We identified subjects via a search of the electronic health record for preterm infants born at ≤32&#xa0;weeks gestational age (GA) with evidence of white matter injury in neuroimaging reports. Head ultrasounds at 7 days and 30&#xa0;days and term-equivalent age MRIs were scored using established scoring systems by three expert readers, with final scoring established by consensus. We used ordinal logistic regression to determine the association between white matter severity on ultrasound and MRI. Multivariable models were adjusted for GA at birth and severity of intraventricular hemorrhage. Neurological outcomes (cerebral palsy, epilepsy, and neurosensory impairment) were determined by medical records review with a median corrected age at follow-up of 23.0&#xa0;months.</p> Results <p>Fifty infants with a median GA at birth of 27.1&#xa0;weeks were included in our retrospective cohort. White matter injury severity on 7-DOL (odds ratio 1.8, 95% CI 1.3-2.6) and 30-DOL (odds ratio 1.5, 95% CI 1.2-2.0) ultrasound was independently associated with severity on MRI. Higher injury severity on 7-DOL ultrasound was associated with cerebral palsy (odds ratio 2.4, 95% CI 1.3-4.3), while higher injury severity on 30-DOL ultrasound was associated with both cerebral palsy (odds ratio 1.7, 95% CI 1.2-2.5) and neurosensory impairment (odds ratio 1.7, 95% CI 1.2-2.4).</p> Conclusion <p>Preterm infants with white matter injury on 7-DOL or 30-DOL head ultrasound are at elevated risk for white matter injury on term-equivalent age brain MRI and for future neurological impairment.</p> Graphical abstract <p></p>

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Early ultrasound-based assessment of preterm white matter injury: association with MRI and neurological outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月18日

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  • Janah May Oclaman,
  • Felicia Tang,
  • Natalie Chan,
  • Katelin Kramer,
  • Ari J. Green,
  • Dawn Gano,
  • Fei Jiang,
  • Kayla Cort,
  • Yi Li,
  • Bridget Elaine LaMonica Ostrem

摘要

Background

White matter injury is a leading cause of neurodevelopmental impairment in premature infants. Timely initiation of novel therapies in clinical development will require early identification of clinically significant white matter injury. Head ultrasound is commonly obtained at 7 days and 30 days of life (DOL) to screen for brain injuries in premature infants.

Objective

To determine if white matter injury severity on head ultrasound at 7 DOL and 30 DOL is associated with white matter injury severity on term-equivalent age MRI and with neurological outcomes through age 2 years.

Materials and methods

We identified subjects via a search of the electronic health record for preterm infants born at ≤32 weeks gestational age (GA) with evidence of white matter injury in neuroimaging reports. Head ultrasounds at 7 days and 30 days and term-equivalent age MRIs were scored using established scoring systems by three expert readers, with final scoring established by consensus. We used ordinal logistic regression to determine the association between white matter severity on ultrasound and MRI. Multivariable models were adjusted for GA at birth and severity of intraventricular hemorrhage. Neurological outcomes (cerebral palsy, epilepsy, and neurosensory impairment) were determined by medical records review with a median corrected age at follow-up of 23.0 months.

Results

Fifty infants with a median GA at birth of 27.1 weeks were included in our retrospective cohort. White matter injury severity on 7-DOL (odds ratio 1.8, 95% CI 1.3-2.6) and 30-DOL (odds ratio 1.5, 95% CI 1.2-2.0) ultrasound was independently associated with severity on MRI. Higher injury severity on 7-DOL ultrasound was associated with cerebral palsy (odds ratio 2.4, 95% CI 1.3-4.3), while higher injury severity on 30-DOL ultrasound was associated with both cerebral palsy (odds ratio 1.7, 95% CI 1.2-2.5) and neurosensory impairment (odds ratio 1.7, 95% CI 1.2-2.4).

Conclusion

Preterm infants with white matter injury on 7-DOL or 30-DOL head ultrasound are at elevated risk for white matter injury on term-equivalent age brain MRI and for future neurological impairment.

Graphical abstract