SYSTEMATIC REVIEW article
Front. Pediatr.
Sec. Pediatric Neurology
Neonatal brain MRI to prognosticate neurodevelopmental outcomes in fetal growth restricted infants: A systematic review
Provisionally accepted
- 1The University of Queensland, Brisbane, Australia
- 2Perth Children's Hospital, Nedlands, Australia
- 3Royal Brisbane and Women's Hospital, Herston, Australia
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Aim: The purpose of this study was to identify magnetic resonance imaging (MRI) brain markers at birth that prognosticate neurodevelopmental outcomes at >≥ 12 months of age in fetal growth restricted (FGR) infants. Methods: A systematic literature search was undertaken in PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus in March 2025. Inclusion criteria of aArticles were assessed by two reviewers. The inclusion criteria included papers relating to infants with birth weight < 10th percentile, with assessed neurodevelopmental outcomes at 12 months of age or older, and MRI performed at birth with markers for neurodevelopment, and comparison of data to appropriate for gestational age (AGA) infants. The quality of studies was assessed using the Cochrane-approved Quality in Prognosis Studies tool. Results: Three articles met the inclusion criteria. A, and all demonstrated a correlation between MRI features in regions of the brain and neurodevelopmental outcomes >12 months of age across all studied infants. However, only one of the three studies correlated early MRI results with neurodevelopmental outcomes specifically in FGR infants and thus a meta-analysis could not be performed. The single study reports a positive correlation between MRI total parenchyma area and cognitive scores in FGR infants. Conclusions: The current literature highlights the developmental risk in FGR versus AGA infants. FGR neonates have significantly different MRI results compared to AGA neonates and MRI findings in the neonate are associated with adverse neurodevelopmental outcomes. However, current evidence is insufficient to firmly establish MRI prognostic capabilities specifically for FGR infants. Sub-group analysis of the FGR cohort in the reported studies and the use of more advanced MRI techniques would likely elucidate this. Further research is required to ascertain robust clinical MRI markers of early adverse brain development in the FGR newborn.
Keywords: Brain, Fetal Growth Retardation, intrauterine growth restriction, Magnetic Resonance Imaging, neurodevelopment, Newborn
Received: 07 Aug 2025; Accepted: 11 Dec 2025.
Copyright: © 2025 Ramdial, MacNamara, Moldrich, Colditz and Wixey. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Julie A Wixey
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