Day 1 Cranial Ultrasonography Detects Prenatal Brain Abnormalities in Preterm Infants: A Retrospective Cohort Study.

Authors

Rim Kasem Ali Sliman, Michal Molad, Dan Waisman, Karen Lavie Nevo, Marina Soloveichick

Published in

Journal of child neurology. Pages 8830738261472010. Aug 18, 2026. Epub Aug 18, 2026.

Abstract

BackgroundCurrent guidelines recommend cranial ultrasonography (CUS) screening at 7-14 days for infants <30 weeks of gestation. However, emerging evidence suggests that significant prenatal brain injuries may be missed by delayed screening protocols.ObjectiveTo evaluate the diagnostic yield of day 1 CUS in identifying prenatal brain abnormalities across all preterm gestational ages.MethodsRetrospective cohort study of 365 preterm infants (24.0-36.6 weeks of gestation) who underwent CUS within 24 hours of birth at a tertiary neonatal intensive care unit (June 2014-July 2020). CUS findings were analyzed by gestational age groups, with particular attention to signs of prenatal hemorrhage and white matter abnormalities. Images were independently reviewed by 2 board-certified neonatologists with consensus review for discordant cases.ResultsDay 1 CUS revealed pathologic findings in 141 of 365 infants (38.6%), with gestational age-dependent prevalence: 44 of 69 (63.8%) extremely preterm (24-30 weeks), 53 of 129 (41.1%) very preterm (30.1-33.6 weeks), and 44 of 167 (26.3%) moderate to late preterm (34-36.6 weeks). Intraventricular hemorrhage (IVH) occurred in 58 of 365 infants (15.9%), with 31 of 58 cases (53.4%) showing clot liquefaction suggestive of prenatal onset. Critically, 14 of 58 IVH cases (24.1%) completely resolved on follow-up imaging. White matter lesions were identified in 49 of 365 infants (13.4%), demonstrating marked gestational age dependence: 25 of 69 (36.2%) extremely preterm, 23 of 129 (17.8%) very preterm, and 1 of 167 (0.6%) moderate-late preterm infants.ConclusionsDay 1 CUS identifies findings suggestive of prenatal brain pathology across all preterm gestational ages. Nearly one-quarter of early IVH cases resolve before conventional screening times. These findings suggest that earlier CUS may warrant further evaluation as a potential adjunct to current protocols; however, prospective studies with neurodevelopmental follow-up are needed before any change to screening practice can be recommended.

PMID:
42610953
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.