Objectives: This narrative review aims to demonstrate how integrating neuroimaging with functional assessments and standardized protocols enhances the identification of long-term motor and psychiatric risks. Methods: This review synthesized 13 high-impact studies, from the last 5 years. The analysis focused on preterm infants (<37 weeks gestational age) and evaluated the correlation between neuroimaging (head ultrasound (HUS), Magnetic Resonance Imaging (MRI)), head circumference (HC), and functional assessments like Prechtl General Movements (GMs). Results: While HUS remains the primary bedside tool, its sensitivity for subtle, non-cystic white matter injury is limited compared to MRI. Both modalities demonstrate high negative predictive values at term-equivalent age (TEA) for excluding severe motor deficits. Structural markers, including increased ventricular midbody size, immature gyration, and bilateral lesion laterality, were strongly associated with Cerebral Palsy (CP) and gross motor delays. Furthermore, TEA assessments provided superior prognostic accuracy compared to early neonatal scans. Optimal outcomes were linked to the integration of neuroimaging with functional assessments (GMs) and reliable parental support to ensure follow-up compliance. Conclusions: A tiered HUS/MRI protocol combined with routine GMs assessment enables precise prognostic counseling. Correlating TEA imaging with long-term findings necessitates follow-up beyond 24 months.

Background and Objectives: Early identification and referral for intervention of former premature infants at risk of neurodevelopmental impairment is considered a standard of care. The main purpose of this review was to assess the optimal timing of the first visit in a neurodevelopmental follow-up programme in order to identify at-risk infants in a timely and reliable manner. Materials and Methods: We considered three possible moments for the first evaluation: before 37 weeks postmenstrual age, at Term Equivalent Age (TEA, also known as 40 weeks postmenstrual age) and at 3–5 months corrected age (CA). A structured scoping review, informed by PRISMA-ScR principles, was performed. We searched PubMed/MEDLINE, Web of Science Core Collection, and Scopus from database inception through March 2026, combined with a Wohlin-type snowballing strategy. Two assessment techniques were evaluated: the Amiel–Tison neurological examination of the newborn and infant, and the General Movements Assessment (GMA). We collected data on sensitivity, specificity, and positive and negative predictive values at each of the three moments, and reviewed whether early intervention was associated with improved prognosis. Results: Intervention initiated before 12 months of age was associated with improved cognitive and motor outcomes in infancy compared with standard care; an additional benefit was observed when intervention started before discharge, particularly for cognitive outcomes in infancy. Both examinations showed very good specificity and negative predictive value at all three evaluation moments, consistent with their shared optimality concept. Sensitivity and specificity increased with the infant’s age. At each moment, the examinations identified (i) a high-risk group clearly requiring early intervention, (ii) a “grey zone” with uncertain evolution requiring closer surveillance, and (iii) a normal group with a very low risk of adverse outcomes. Combining two examination techniques at the same visit consistently improved discriminative and predictive performance. Conclusions: Evaluation at TEA alone may be too early because some abnormal findings normalize by 3 months CA, yet also too late for the most severely affected infants, who may manifest abnormal signs before term. We propose a stratified approach, with repeated evaluations using both the Amiel–Tison examination and GMA at 35–37 weeks postmenstrual age, at TEA, and at 3–5 months CA, in order to progressively identify infants at risk and refer them to appropriate early intervention. This proposal requires validation through prospective, well-designed research.

This narrative review aims to demonstrate how integrating neuroimaging with functional assessments and standardized protocols enhances the identification of long-term motor and psychiatric risks. This review synthesized 12 studies from the last 5 years. The analysis focused on preterm infants (<37 weeks’ gestational age) and evaluated the correlation between neuroimaging (head ultrasound (HUS) and Magnetic Resonance Imaging (MRI)), head circumference (HC), and functional assessments like Prechtl General Movements (GMs). While HUS remains the primary bedside tool, its sensitivity for subtle, non-cystic white matter injury is limited compared to MRI. Both modalities demonstrate high negative predictive values at term-equivalent age (TEA) for excluding severe motor deficits. Structural markers, including increased ventricular midbody size, immature gyration, and bilateral lesion laterality, were strongly associated with Cerebral Palsy (CP) and gross motor delays. Furthermore, TEA assessments provided superior prognostic accuracy compared to early neonatal scans. Optimal outcomes were linked to the integration of neuroimaging with functional assessments (GMs) and reliable parental support to ensure follow-up compliance. A tiered HUS/MRI protocol combined with routine GMs assessment enables precise prognostic counseling. Correlating TEA imaging with long-term findings necessitates follow-up beyond 24 months.