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This review aims to provide readers with an understanding of 1) the basic principles and technical considerations relevant to\n                      <jats:sup>1<\/jats:sup>\n                      H\u2010MRS in the fetal\u2010neonatal brain and 2) the role of\n                      <jats:sup>1<\/jats:sup>\n                      H\u2010MRS in early fetal\u2010neonatal development brain research. We performed a PubMed search to identify original studies using\n                      <jats:sup>1<\/jats:sup>\n                      H\u2010MRS in neonates and fetuses to establish the clinical applications of\n                      <jats:sup>1<\/jats:sup>\n                      H\u2010MRS. The eligible studies for this review included original research with\n                      <jats:sup>1<\/jats:sup>\n                      H\u2010MRS applications to the fetal\u2010neonatal brain in healthy and high\u2010risk conditions. We ran our search between 2000 and 2023, then added in several high\u2010impact landmark publications from the 1990s. A total of 366 results appeared. After, we excluded original studies that did not include fetuses or neonates, non\u2010proton MRS and non\u2010neurological studies. Eventually, 110 studies were included in this literature review. Overall, the function of\n                      <jats:sup>1<\/jats:sup>\n                      H\u2010MRS in healthy fetal\u2010neonatal brain studies focuses on measuring the change of metabolite concentrations during neurodevelopment and the physical properties of the metabolites such as\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>1<\/jats:sub>\n                      \/\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>2<\/jats:sub>\n                      relaxation times. For high\u2010risk neonates, studies in very low birth weight preterm infants and full\u2010term neonates with hypoxic\u2013ischemic encephalopathy, along with examining the associations between brain biochemistry and cognitive neurodevelopment are most common. Additional high\u2010risk conditions included infants with congenital heart disease or metabolic diseases, as well as fetuses of pregnant women with hypertensive disorders were of specific interest to researchers using\n                      <jats:sup>1<\/jats:sup>\n                      H\u2010MRS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Level<\/jats:title>\n                    <jats:p>1<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Technical Efficacy<\/jats:title>\n                    <jats:p>Stage 2<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmri.29709","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T06:20:27Z","timestamp":1737440427000},"page":"2404-2424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Role of Proton Magnetic Resonance Spectroscopy in Neonatal and Fetal Brain Research"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1523-4040","authenticated-orcid":false,"given":"Steve C.N.","family":"Hui","sequence":"first","affiliation":[{"name":"Developing Brain Institute, Children's National Hospital  Washington D.C. 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