CMRI-detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infants
Abstract Neurological impairment is high after preterm birth. This study evaluates the impact and interplay of cMRI-detected brain injuries (BI) and clinical risk factors on neurodevelopmental outcomes and extracts the most important key factors. A retrospective analysis was conducted on risk factor...
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Nature Portfolio
2025-05-01
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| Online Access: | https://doi.org/10.1038/s41598-025-02539-1 |
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| author | Karla Drommelschmidt Thomas Mayrhofer Hanna Müller Borek Foldyna Janika Raudzus Sophia L. Göricke Bernd Schweiger Selma Sirin |
| author_facet | Karla Drommelschmidt Thomas Mayrhofer Hanna Müller Borek Foldyna Janika Raudzus Sophia L. Göricke Bernd Schweiger Selma Sirin |
| author_sort | Karla Drommelschmidt |
| collection | DOAJ |
| description | Abstract Neurological impairment is high after preterm birth. This study evaluates the impact and interplay of cMRI-detected brain injuries (BI) and clinical risk factors on neurodevelopmental outcomes and extracts the most important key factors. A retrospective analysis was conducted on risk factors (perinatal/neonatal, cMRI-detected BI) for adverse motor (MO) and cognitive (CO) outcomes (Bayley Scales of Infant Development, 24 months corrected age) in a tertiary center cohort (2009–2018) of very preterm infants (< 32 weeks of gestation) using uni-/multivariable regression models. We included 342 infants (mean gestational age:28.0 ± 2.3 weeks; male:49%). Significant clinical predictors for MO/CO included GA, birthweight, APGAR score, catecholamine treatment, ventilation, retinopathy of prematurity, transfusion of red blood cells (RBCs), bronchopulmonary dysplasia, surgery, and patent ductus arteriosus interventions (all p < 0.01/p < 0.01), surfactant (MO: p = 0.037), and sepsis (p < 0.001/p = 0.016). (Severe) cMRI-detected BIs (> 1, all p < 0.05) and not only severe intraventricular hemorrhage (IVH) III°/III°+PVHI and ventricular dilatation (VD) (all p < 0.05), but also mild/moderate injuries like IVH II° (p < 0.001/p < 0.024), cerebellar hemorrhage (CO: p = 0.028), and moderate VD (MO: p = 0.005) significantly impacted outcomes. Independent key factors were > 1 severe cMRI-detected BI (MO/CO:-11.27/-10.3 score points (sp), p = 0.021/0.043), APGAR score (10 min, MO/CO:+5.3/+4.45 sp/point, p < 0.001/p < 0.001), surfactant administration (MO:+4.88 sp, p = 0.031), and transfusion of RBCs (MO/CO:-1.69/-1.96 sp/transfusion, p = 0.006/p < 0.001). In conclusion, combining imaging and clinical (key) risk factors is important for risk stratification of preterm infants. Even mild BI, like IVH II°, significantly contributes to adverse outcomes, underlining the importance of cMRI. |
| format | Article |
| id | doaj-art-b5b9f738c2c74c5db5384c3a5af9bcf1 |
| institution | Kabale University |
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| publishDate | 2025-05-01 |
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| spelling | doaj-art-b5b9f738c2c74c5db5384c3a5af9bcf12025-08-20T03:48:18ZengNature PortfolioScientific Reports2045-23222025-05-0115112010.1038/s41598-025-02539-1CMRI-detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infantsKarla Drommelschmidt0Thomas Mayrhofer1Hanna Müller2Borek Foldyna3Janika Raudzus4Sophia L. Göricke5Bernd Schweiger6Selma Sirin7Department of Pediatrics I, Neonatology, Pediatric Intensive Care, and Pediatric Neurology, University Hospital Essen, University of Duisburg-EssenSchool of Business Studies, Stralsund University of Applied SciencesDivision of Neonatology, Department of Pediatrics, University Hospital of TuebingenDepartment of Radiology Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical SchoolSchool of Business Studies, Stralsund University of Applied SciencesDepartment of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-EssenDepartment of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-EssenDepartment of Diagnostic Imaging, University Children’s Hospital Zurich University of ZurichAbstract Neurological impairment is high after preterm birth. This study evaluates the impact and interplay of cMRI-detected brain injuries (BI) and clinical risk factors on neurodevelopmental outcomes and extracts the most important key factors. A retrospective analysis was conducted on risk factors (perinatal/neonatal, cMRI-detected BI) for adverse motor (MO) and cognitive (CO) outcomes (Bayley Scales of Infant Development, 24 months corrected age) in a tertiary center cohort (2009–2018) of very preterm infants (< 32 weeks of gestation) using uni-/multivariable regression models. We included 342 infants (mean gestational age:28.0 ± 2.3 weeks; male:49%). Significant clinical predictors for MO/CO included GA, birthweight, APGAR score, catecholamine treatment, ventilation, retinopathy of prematurity, transfusion of red blood cells (RBCs), bronchopulmonary dysplasia, surgery, and patent ductus arteriosus interventions (all p < 0.01/p < 0.01), surfactant (MO: p = 0.037), and sepsis (p < 0.001/p = 0.016). (Severe) cMRI-detected BIs (> 1, all p < 0.05) and not only severe intraventricular hemorrhage (IVH) III°/III°+PVHI and ventricular dilatation (VD) (all p < 0.05), but also mild/moderate injuries like IVH II° (p < 0.001/p < 0.024), cerebellar hemorrhage (CO: p = 0.028), and moderate VD (MO: p = 0.005) significantly impacted outcomes. Independent key factors were > 1 severe cMRI-detected BI (MO/CO:-11.27/-10.3 score points (sp), p = 0.021/0.043), APGAR score (10 min, MO/CO:+5.3/+4.45 sp/point, p < 0.001/p < 0.001), surfactant administration (MO:+4.88 sp, p = 0.031), and transfusion of RBCs (MO/CO:-1.69/-1.96 sp/transfusion, p = 0.006/p < 0.001). In conclusion, combining imaging and clinical (key) risk factors is important for risk stratification of preterm infants. Even mild BI, like IVH II°, significantly contributes to adverse outcomes, underlining the importance of cMRI.https://doi.org/10.1038/s41598-025-02539-1Pediatric researchBrain injuriesMagnetic resonance imagingNeurodevelopmental outcomesPreterm infants |
| spellingShingle | Karla Drommelschmidt Thomas Mayrhofer Hanna Müller Borek Foldyna Janika Raudzus Sophia L. Göricke Bernd Schweiger Selma Sirin CMRI-detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infants Scientific Reports Pediatric research Brain injuries Magnetic resonance imaging Neurodevelopmental outcomes Preterm infants |
| title | CMRI-detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infants |
| title_full | CMRI-detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infants |
| title_fullStr | CMRI-detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infants |
| title_full_unstemmed | CMRI-detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infants |
| title_short | CMRI-detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infants |
| title_sort | cmri detected brain injuries and clinical key risk factors associated with adverse neurodevelopmental outcomes in very preterm infants |
| topic | Pediatric research Brain injuries Magnetic resonance imaging Neurodevelopmental outcomes Preterm infants |
| url | https://doi.org/10.1038/s41598-025-02539-1 |
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