Prevalence and Risk Factors of Incidental Findings in Brain MRIs of Healthy Neonates—The FinnBrain Birth Cohort Study

Abstract

Background: Birth is a traumatic event with molding forces directed to the fetal skull, which may result in intracranial hemorrhages. However, the knowledge on prevalence and risk factors of incidental brain magnetic resonance imaging (MRI) findings in infants is still inconclusive. Methods: The prevalence and nature of incidental MRI findings were assessed in a birth cohort of 175 asymptomatic infants. The role of delivery method as well as other potential risk factors for intracranial hemorrhages were evaluated. The infants underwent 3T MRI at the age of 2-5 weeks, and the neurological status of the infants with an incidental finding was evaluated by a pediatric neurologist. Information on the delivery method, duration of delivery, parity, used anesthesia, oxytocin induction, and Apgar score was gathered to evaluate their association with the prevalence of hemorrhages. Results: Incidental intracranial hemorrhages were detected in 12 infants (6.9%), all following spontaneous or assisted vaginal delivery. Vacuum-assistance was found to be a risk factor for subdural hemorrhages with an odds ratio (OR) of 4.7 (95% CI [1.18; 18.9], p = 0.032). All infants were evaluated to develop normally by their clinical status. Conclusions: Incidental intracranial hemorrhages are relatively common among infants born by vaginal delivery. They are often of little clinical significance within the first years of life and have unlikely consequences for later neurodevelopment either. Despite their benign character, investigators should be prepared to share this information with parents competently as the findings can cause parental anxiety, and especially as the popularity of MRI as a research tool is increasing.

Incidence of brain lesions in moderate-late preterm infants assessed by cranial ultrasound and MRI: The BIMP-study

“…Contrary to the low incidence of IVH, the incidence of CBH (12.6 % in our cohort) was similar to reported incidences in very preterm populations [34]. Furthermore, subdural hemorrhage was not detected in our cohort, while this is the most often reported hemorrhage in otherwise healthy full-term infants [32,35]. These differences with very preterm and full-term infants underpin that MLPT infants should be seen as a different group.…”

Newborn amygdalar volumes are associated with maternal prenatal psychological distress in a sex-dependent way

“…Developmental status was age appropriate by the age of two years for all participants. The incidental findings (intracranial hemorrhages, N = 12, 6.9%) have been found to be common and clinically insignificant in previous studies ( Kumpulainen et al, 2020 , Rooks et al, 2008 , Whitby et al, 2004 ). Intracranial hemorrhages were minor, situated far from the regions of interest and were deemed to be clinically insignificant by the pediatric neuroradiologist (author RP), and thus, these individuals were not excluded from the current study.…”

Newborn left amygdala volume associates with attention disengagement from fearful faces at eight months

“…If those were found, parents were given a follow-up opportunity with a pediatric neurologist. Developmental status has thereafter been normal for all of the participants Kumpulainen V et al, 2020 . The incidental findings have been found to be common and clinically insignificant in previous studies ( Rooks et al, 2008 ; Whitby et al, 2004 ), and were deemed not to affect the volumetric estimates of interest.…”