Relationship between MRI scoring systems and neurodevelopmental outcome at 2 years in infants with Neonatal encephalopathy

Abstract Background Magnetic resonance imaging (MRI) scoring systems are used in the neonatal period to predict outcome in infants with neonatal encephalopathy (NE). Our aim was to assess the relationship between 3 MRI scores and neurodevelopmental outcome assessed using Bayley Scales of Infant and Toddler Development, third edition (Bayley-III) at 2 years in infants with NE. Methods Term-born neonates with evidence of perinatal asphyxia born between 2011 to 2015 were retrospectively reviewed. MRI scanning was performed within the first two weeks of life and scored using Barkovich, NICHD NRN and Weeke systems by a single assessor blinded to the infants clinical course. Neurodevelopmental outcome was assessed using composite scores on the Bayley-III at 2 years. Multiple linear regression analyses were used to assess the association between MRI scores and Bayley-III composite scores, with postmenstrual age at scan and sex included as covariates. Results Of the 135 recruited infants, 90 infants underwent MRI and of these 66 returned for follow-up. MRI abnormalities were detected with the highest frequency using the Weeke score (Barkovich 40%, NICHD NRN 50%, Weeke 77%). The inter-rater agreement was good for the Barkovich score, and excellent for NICHD NRN and Weeke scores. There was a significant association between Barkovich, NICHD NRN and Weeke scores and Bayley-III cognitive and motor scores. Only the Weeke score was associated with Bayley-III language scores. Conclusions Our findings confirm the predictive value of existing MRI scoring systems for cognitive and motor outcome, and suggest that more detailed scoring systems have predictive value for language outcome.