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The reliability of scoring and the incidence and evolution of white matter injury in moderate-late preterm infants is unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>To assess inter-observer variability in white matter injury using a published scoring system (UCSF system), and to describe changes over time in moderate-late preterm infants.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Infants born between 32\u2009+\u20090 and 36\u2009+\u20096\u00a0weeks\u2019 gestation in the Auckland region underwent MRI scans as soon as clinically feasible after birth and again at term-equivalent age. De-identified scans were scored independently by two observers. White matter injury was graded as minimal (&lt;\u20093 lesions measuring\u2009&lt;\u20092\u00a0mm), moderate (&gt;\u20093 lesions or lesions\u2009&gt;\u20092\u00a0mm), or severe (&gt;\u20095% hemispheric involvement). Scores were compared between reviewers using weighted and unweighted kappa statistics interpreted using Cohen\u2019s criteria. Incidences were compared between scans using generalised estimating equations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Scans of 101 infants were assessed. Inter-observer agreement was near perfect for the presence of white matter injury (<jats:italic>k<\/jats:italic>\u2009=\u20090.88 and 0.81 for the first and second scan respectively), and for the severity of white matter injury was near perfect at the first scan (<jats:italic>k<\/jats:italic>\u2009=\u20090.85) and substantial at the second scan (<jats:italic>k<\/jats:italic>\u2009=\u20090.80). The incidence of white matter injury detected by the two observers decreased between the first and second scans (30% to 22% and 29% to 19%), and severity also decreased.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This scoring system can be reliably applied in moderate-late preterm infants. White matter injury is common in moderate-late preterm infants but may be underestimated when MRI is performed close to term-equivalent age.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00247-025-06297-0","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T03:16:57Z","timestamp":1750389417000},"page":"1682-1689","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inter-observer variability in scoring of white matter injury on brain magnetic resonance imaging in moderate-to-late preterm infants"],"prefix":"10.1007","volume":"55","author":[{"given":"Kyle","family":"Grabowski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liam","family":"Olsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg","family":"Gamble","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Perry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Harding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"6297_CR1","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.siny.2012.02.001","volume":"17","author":"S Petrou","year":"2012","unstructured":"Petrou S, Khan K (2012) Economic costs associated with moderate and late preterm birth: primary and secondary evidence. 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