Neonatal neurocritical care considerations for prenatally identified neurological disorders

Dawn Gano, Department of Pediatrics, BC Children's Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada. dawn.gano@ubc.ca.
James P. Boardman, Centre for Reproductive Health, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, UK.
Sonika Agarwal, Division of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Charu Venkatesan, Department of Pediatrics, Division of Neurology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA.
Tomo Tarui, Division of Pediatric Neurology, Hasbro Children's, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Vann Chau, Department of Pediatrics (Neurology), The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada.
Courtney J. Wusthoff, Department of Neurology, University of California Davis, Sacramento, CA, USA.
Monica E. Lemmon, Departments of Pediatrics and Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Barbara Scelsa, Department of Pediatric Neurology, Buzzi Children's Hospital, Milan, Italy.
Brigitte Vollmer, Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
Sarah B. Mulkey, Zickler Family Prenatal Pediatrics Institute, Children's National Hospital, Washington, DC, USA.
Mark S. Scher, Departments of Pediatrics and Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Anthony R. Hart, Department of Paediatric Neurology, King's College Hospital NHS Foundation Trust, London, UK.
Eric S. Peeples, Department of Pediatrics, University of Nebraska Medical Center, Children's Nebraska, Child Health Research Institute, Omaha, NE, USA.
Firdose Nakwa, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Eleanor Molloy, Discipline of Paediatrics, School of Medicine, Trinity College Dublin, the University of Dublin, Dublin, Ireland.
Andrea C. Pardo, Department of Pediatrics (Neurology and Epilepsy), Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Document Type

Journal Article

Publication Date

1-7-2026

Journal

Pediatric research

DOI

10.1038/s41390-025-04691-w

Abstract

With increased access to advanced prenatal neuroimaging and genetic testing, neurological disorders such as brain malformations, brain injuries, and genetic disorders, are increasingly being diagnosed during pregnancy. In this review, we address neonatal neurocritical care considerations for the population with prenatally identified neurological disorders. We identify antenatal considerations, including planning location of delivery, as well as postnatal considerations, including clinical phenotyping, neuromonitoring, neuroimaging, and genetic testing. The importance of interdisciplinary collaboration between obstetrics, maternal-fetal medicine, neonatology, pediatric neurology, neuroradiology, genetics, palliative care, early intervention and habilitative services is emphasized. We outline high-priority research gaps, and highlight the need for large, multicenter studies that capture diverse geographies, populations, care practices and settings longitudinally. IMPACT: Fetal neurology is a rapidly evolving field owing to the increased prenatal diagnosis of neurological disorders; however, the natural history of many fetal neurological disorders is not well known. We identify interdisciplinary neonatal neurocritical care considerations for newborns with prenatally diagnosed neurological disorders, such as neuroimaging, neuromonitoring, and family support. We outline high-priority research gaps in fetal neurology relevant to neurocritical care, including the need to prioritize large-scale longitudinal studies on the etiologies, short- and long-term outcomes of fetal neurologic disorders across diverse geographies and populations to improve counseling and care.

Department

Neurology

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