Abstract :
Keywords Cranial ultrasonography; Brain size; Brain growth; Preterm infant; Neurobehaviour Highlights * Early postnatal brain size and brain growth relate to neurobehaviour at term-equivalent age in infants born at * Postnatal brain size and brain growth can be readily assessed at the bedside using sequential cranial ultrasonography * Early postnatal cranial ultrasonography linear measures may be potential markers of later neurodevelopment Abstract Background The relationship between early postnatal brain development and neurobehaviour at term-equivalent age (TEA) remains uncertain. Aim We aimed to explore relationships between early postnatal cranial ultrasonography (cUS) linear measures of brain size and brain growth with neurobehaviour at TEA in infants born Study design Prospective observational cohort study. Subjects 137 infants born Outcome measures Neurobehaviour at TEA assessed using the General Movements Assessment (GMA) and Hammersmith Neonatal Neurological Examination (HNNE). Results The GMA was administered in 115/137 (84%) infants; 80 (70%) presented with abnormal general movements (GMs) (79 poor repertoire, 1 cramped synchronised). The HNNE was assessed in 106/137 (77%) infants; 52 (49%) had a suboptimal total score. With respect to brain size, larger measures of the corpus callosum length (CCL) and right anterior horn width (AHW) at 1-month were related to lower risk of abnormal GMs, and larger measures of the biparietal diameter at 1-week and 2-months were related to lower risk of a suboptimal HNNE. As for brain growth, increases of the CCL and transcerebellar diameter between birth and 1-month, and left and right AHWs between 1- and 2-months, were related to lower risk of abnormal GMs. Conclusion Early postnatal brain size and brain growth were related to neurobehaviour at TEA in infants born Abbreviations AHW, anterior horn width; BPD, biparietal diameter; BW, birth weight; CCL, corpus callosum length; cUS, cranial ultrasonography; GA, gestational age; GMA, General Movements Assessments; GMH-IVH, germinal matrix haemorrhage-intraventricular haemorrhage; GMs, general movements; HNNE, Hammersmith Neonatal Neurological Examination; IHD, interhemispheric distance; MRI, magnetic resonance imaging; PNA, postnatal age; PVL, periventricular leukomalacia; TCD, transcerebellar diameter; TEA, term-equivalent age; VH, vermis height; VW, ventricular width Author Affiliation: (a) Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia (b) Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia (c) Department of Paediatrics, The University of Melbourne, Melbourne, Australia (d) Department of Physiotherapy, The University of Melbourne, Melbourne, Australia (e) Neonatal Services, The Royal Women's Hospital, Melbourne, Australia (f) Department of Paediatrics, Monash University, Melbourne, Australia (g) Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia (h) Department of Paediatrics, Imperial College, London, United Kingdom * Corresponding author at: Newborn Research, The Royal Women's Hospital, Level 7, 20 Flemington Road, Parkville, 3052, Victoria, Australia. Article History: Received 24 May 2021; Revised 24 November 2021; Accepted 30 November 2021 Byline: Rocco Cuzzilla [rocco.cuzzilla@thewomens.org.au] (a,b,e,*), Joy E. Olsen (a,e), Abbey L. Eeles (a,d,f), Sheryle R. Rogerson (e), Peter J. Anderson (a,g), Frances M. Cowan (h), Lex W. Doyle (a,b,c,e), Jeanie L.Y. Cheong (a,b,e), Alicia J. Spittle (a,d,e)