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Evaluation of MR imaging to predict neurodevelopmental impairment in preterm infants

MRI scans can be used to predict neurodevelopmental impairments in preterm infants. Birmingham City University conducted research to provide the NHS with an evidence base to advise whether MRI scanning was an effective tool in this context.

MRI for preterm infants large

Researchers

  • Merryl Harvey
  • AD Edwards (Imperial College / King’s College London) - Lead applicant/chief investigator 

Co-applicants/principal investigators: 

ME Redshaw, N Kennea, D Azzopardi, M Rutherford, F Cowan, S Counsell, P Brocklehurst, O Eddama, I de Vega

Research background

NIHR funded programme of work consisting of component projects:

  1. To determine with high precision the sensitivity and specificity of cerebral MR imaging for predicting neurodevelopmental impairment in the context of the NHS
  2.  An RCT to compare the effect of MR and ultrasound imaging on total healthcare usage and costs, and assess its effect on unplanned and planned care
  3. To compare the influence of MR- and ultrasound-based information on parental perceptions, stress and coping
  4. To compare routine local bedside with specialist centralised ultrasound imaging
  5. To survey MR use and capacity in the NHS
  6. To develop further novel MR methods to predict neurodevelopmental impairment.

Research aims

The overall aim of this programme was to provide the evidence-base for NHS policy on the use of magnetic resonance (MR) imaging of the brain for preterm infants.

Research methods

The main component of this programme of work was an RCT to compare the effect of prognostic information based on either MRI or ultrasound scan was undertaken at the term of babies born before 33 weeks. Parental anxiety and coping were measured using qualitative and quantitative approaches over the following two years to explore and test the impact of scanning information on family wellbeing.

MRI increased costs and provided only modest benefits. The findings suggest that not all preterm infants should be offered MRI.

Main study paper:

Edwards, A.D. Redshaw, M.E. Kennea, N. Rivero-Arias,O Gonzales-Cinca, N. Nongena, P. Ederies, M. Falconer, S. Chew, A. Omar, O. Hardy, P. Harvey, M.E. Eddama, O. Hayward, N. Wurie, J. Azzopardi, D. Rutherford, M.A. Counsell, S. on behalf of the ePrime Investigators (2017) Effect of MRI on preterm infants and their families: a randomised trial with nested diagnostic and economic evaluation Archives of Disease in Childhood Fetal & Neonatal Edition doi:10.1136/archdischild-2017-313102

Publications of the qualitative elements of the study:

Harvey, M.E. Nongena, P. Edwards, A.D. Redshaw, M.E. (2017) ‘We knew it was a totally random thing’: parents’ experiences of being part of a neonatal trialTrials DOI 10.1186/s13063-017-2112-3

Harvey, M.E. Redshaw, M.E. (2016) Qualitative study of the clinician-parent interface in discussing prognosis following MRI and US imaging of preterm infants in the UK   BMJ Open 6: e011472 doi:10.1136/bmjopen-2016-011472 DOI 10.1186/s12887-016-0561-6

Redshaw, M.E. Harvey, M.E. (2016) Explanations and information-giving: clinician strategies used in talking to parents of preterm infants BMC Pediatrics 16 25 DOI 10.1186/s12887-016-0561-6