Neuroimaging and neurodevelopmental outcome in extremely preterm XXXX .

@entity1 @entity227 @entity73 @entity245 @entity76 @entity62 @entity204
BACKGROUND: Extremely preterm @entity1 are at risk for @entity245 ( @entity245 ). Early cranial ultrasound (CUS) is usual practice, but near-term brain MRI has been reported to better predict outcomes. We prospectively evaluated MRI @entity62 ( @entity62 ) and @entity76 , and serial CUS adverse findings as predictors of outcomes at 18 to 22 months' corrected age. METHODS: Early and late CUS, and brain MRI were read by masked central readers, in a large cohort (n = 480) of @entity1 <28 weeks' gestation surviving to near term in the Neonatal Research Network. Outcomes included @entity245 or @entity204 after neuroimaging, and significant gross @entity73 or @entity204 , with @entity245 defined as cognitive composite score <70, significant gross @entity73 , and severe @entity227 . Multivariable models evaluated the relative predictive value of neuroimaging while controlling for other factors. RESULTS: Of 480 @entity1 , 15 died and 20 were lost. Increasing severity of @entity62 and significant @entity76 on MRI were associated with adverse outcomes. @entity76 were rarely identified by CUS. In full multivariable models, both late CUS and MRI, but not early CUS, remained independently associated with @entity245 or @entity204 ( @entity76 : odds ratio, 3.0 [95% confidence interval: 1.3-6.8]; late CUS: odds ratio, 9.8 [95% confidence interval: 2.8-35]), and significant gross @entity73 or @entity204 . In models that did not include late CUS, MRI moderate-severe @entity62 was independently associated with adverse outcomes. CONCLUSIONS: Both late CUS and near-term MRI abnormalities were associated with outcomes, independent of early CUS and other factors, underscoring the relative prognostic value of near-term neuroimaging.
