A systematic review of pre- and postnatal ultrasound measurements for assessing brain growth: Reliability and implications for clinical practice.

BACKGROUND AND AIM: The aim of this systematic review was to identify and assess the reliability of pre- and postnatal ultrasound measurements for evaluating early longitudinal brain growth. The secondary aim was to provide a reliable and feasible set of pre- and postnatal ultrasound measurements for clinical practice and future research.

METHODS

This review was conducted according to PRISMA guidelines and used the validated QAREL scale to assess the risk of bias in the included studies. We included studies assessing the reliability of prenatal and/or postnatal ultrasound measurements. Articles were excluded if intraclass correlation coefficients for intra- or interobserver agreement were not provided. The primary outcome was the intraclass correlation coefficient (ICC) of the intra- and inter-observer agreement.

RESULTS

A total of twenty-two studies were included, in which one study assessed both pre- and postnatal brain growth measurements, eleven studies focused on prenatal measurements, and ten on postnatal measurements. In these studies, twenty-seven prenatal and thirty-two postnatal ultrasound measurements were used to assess brain growth, showing predominantly good or excellent intra- and interobserver reliability.

CONCLUSIONS

This review highlighted a significant gap in studies assessing longitudinal brain growth from the pre- to the postnatal period. Therefore, collaboration between obstetricians, radiologists and neonatologists is important for assessing longitudinal brain growth, which could help identify infants at risk of abnormal brain growth and potential neurodevelopmental impairment. We propose a set of ultrasound measurements of total brain size, ventricles, cerebellum, and corpus callosum to monitor early brain growth.