The Relationship Between Sonographically Assessed Volumetric Brain Development in VLBW Preterm Infants and Neurodevelopmental Outcome at 2 Years of Age – Data from the NeoNEVS Project

Abstract Background Neurodevelopmental impairment is a major long-term risk in very low birth weight (VLBW) preterm infants. Early identification of at-risk infants is essential. Cranial ultrasound enables safe, serial monitoring of brain growth. Objective To evaluate whether longitudinal brain volume growth, measured by ultrasound, predicts neurodevelopmental outcomes at two years corrected age. Methods Retrospective cohort study, 79 VLBW infants (<1500 g, <32 weeks gestation), two tertiary centers (2019–2021), serial cranial ultrasounds from birth to discharge. Brain volume was estimated using an ellipsoid model. Bayley-III scores at 24 months were correlated with growth trajectories, including gestational-age subgroup analyses. Results Median cerebral growth rate was 2.3 cm³/day (95% CI: 1.5–3.1). Brain growth correlated significantly with Bayley-III motor scores (r = 0.25, p < 0.05) but not cognitive or language outcomes. Discussion Ultrasound-derived brain growth is linked to motor outcomes and may provide a practical marker for early neurodevelopmental risk stratification in VLBW infants.