Re-evaluating the timing of sequential cranial ultrasound screening in very preterm infants for predicting neurodevelopmental outcomes.

objectiveAccurate and early prediction of neurodevelopmental impairment is a crucial endeavor in caring for very preterm infants (<31 weeks' gestation). Sequential cranial ultrasound is the standard of care for the evaluation of preterm brain injury. However, there is no consensus on the timing and frequency of ultrasound screening. At Izaak Walton Killam (IWK) Health Centre, Halifax, Canada, four-time points for routine ultrasound of very preterm infants are performed at weeks 1, 2, 6, and term age. The hypothesis behind this work is that a three-time-point model will be appropriate for neurodevelopmental impairment prognostication. MATERIALS AND

methodsIn this retrospective cohort, all very preterm infants (22

conclusionIn this cohort of very preterm infants, a model including 6-week ultrasound only was comparable to a reference model combining 2-week and 6-week ultrasound and showed nearly identical predictive performance of neurodevelopmental impairment at 36 months corrected age across a broad set of metrics; thus, it is redundant to do both the 2-week and 6-week ultrasound. CLINICAL RELEVANCE STATEMENT: Late ultrasound at 6 weeks of age provided comparable diagnostic and prognostic information to a reference model combining 2-week and 6-week ultrasound and, if anything, was slightly superior to the 2-week ultrasound model, across a broad set of metrics. The 2-week ultrasound can be eliminated with no impact on the prediction of neurodevelopmental impairment at 36 months, promoting prudent resource allocation and stewardship in healthcare.