Evaluation of the correlation of the new Ballard scoring with the ultrasonographic optical nerve sheath diameter and brain volume of preterm infants

Background: Optic nerve sheath diameter (ONSD) measurements with magnetic resonance imaging and ultra-sonography in preterm infants are similar. Aim: We measured ultrasonographic ONSD and calculated the brain volumes of preterm infants using two-dimensional cranial ultrasonography and explored the relationships thereof with gestational age, birth weight, head circumference, and new Ballard score. Method: This prospective study included preterm infants admitted to the neonatal intensive care unit without intracranial pathology. Two images per eye were obtained from a linear array ultrasound transducer placed on the patient's superior eyelid. The ONSD was measured 3 mm behind the globe. The brain was considered an ellipsoid, and estimated absolute brain volumes were calculated by subtracting the volumes of the two lateral ventricles from the total brain volumes. Results: A total of 143 preterm infants (male 74, female 69) included in the study. The mean gestational age of the study population was 29.7 weeks (23-36), and the mean birth weight was 1390 g (500-2850). There was a significant difference in ONSD between the male and female gender. A significant, strong, and positive corre-lation was found between ONSD measurements and gestational age (r 0.901, p < 0.001), new Ballard score (r 0.946, p < 0.001), birth weight, head circumference, and brain volumes. Conclusion: Our results suggested that ONSD measurements are highly correlated with anthropometry, and it could be a promising bedside, non-invasive objective tool for the determination of exact gestational age post-natally along with the new Ballard score.