Background: Preterm neonates face significant health challenges, with outcomes influenced by various maternal, neonatal and clinical factors. As the formation and maturation of central nervous system of preterm neonates is incomplete, they are more vulnerable to brain injury. In this study we have assessed the role of Neurosonography in early diagnosis of intracranial pathologies in preterm neonates.

Methods: This study involved a retrospective analysis of 100 preterm neonates admitted to Quaternary care hospital's NICU. We assessed demographic data, maternal and neonatal risk factors, clinical presentations, and neurosonography findings.

Results: The gender distribution was nearly equal (51% female, 49% male). Most neonates had a birth weight >1.5 kg (77%) and were ≤34.0 weeks gestation (54%). High prevalence of abnormal maternal risk factors was noted, including PPROM (28%), GDM (14%), and eclampsia (10%). Mechanical ventilation was required in 47% of cases. Common co-morbidities were RDS (37%), TTN (33%), and Neonatal Hyperbilirubinemia (27%). Neurosonography showed a high incidence of abnormalities (55%), with Germinal Matrix Hemorrhage (36%) and Cystic-Periventricular Leukomalacia (18%) being significant. A strong correlation was observed between lower birth weight, earlier gestation, and abnormal neurosonography findings (P values 0.038* and 0.033*).

Conclusion: There was moderately significant association between abnormal NSG and gestational age and birth weight. Most common intracranial abnormality detected through NSG was Germinal matrix haemorrhage and it carried the highest mortality. RDS, Severe RDS, TTN, Neonatal Sepsis, Neonatal hyperbilirubinemia had significant with abnormal NSG. This study concludes that early neurosonography in preterm neonates’ aids in predicting abnormal neurological outcome and preventing long term sequelae.