Diagnostic accuracy of early neonatal MRI in predicting adverse motor outcomes in children born preterm: Systematic review and meta-analysis

Each year, around 15 million infants are born preterm worldwide (before 37 weeks of pregnancy). Infants born preterm are more likely to have motor difficulties such as cerebral palsy (CP) or developmental coordination disorder (DCD). Identifying infants who are at-risk of these adverse outcomes is important so they can receive early intervention.

Magnetic resonance imaging (MRI) of the brain is a promising tool to identify early signs of injury among at-risk infants. Most research focuses on MRI performed once the infant reaches term age (approximately 40 weeks); however, infants born preterm are usually discharged from hospital before they reach term age.

We performed a systematic review of the literature to see if MRI performed before 36 weeks since conception could be used to identify these at-risk infants. This included 27 studies published up to October 2023 that evaluated the effectiveness of Early MRI to predict an outcome of CP and poorer motor outcomes in childhood among infants born preterm.

We found that brain injury in newborn infants observed on Early MRI reported by eight studies was able to predict children with CP by the age of 2 or older with a high accuracy. Four additional studies found these Early MRIs were also accurate at identifying children who would have age-appropriate motor ability by 3 years or older, but may miss children who develop mild or moderate motor difficulties.