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This is a prospective cohort study with consecutive inclusion of VLBWI\u2009\u2264\u200932\u00a0weeks gestational age and\u2009\u2264\u20091500\u00a0g at birth. Total brain volume (TBV) was assessed using sequential 3D-US from birth to discharge. Prognosis at 2\u00a0years (corrected age) was assessed using the Bayley Scales of Infant and Toddler Development Third Edition. TBV showed slower growth with postmenstrual age (PMA) in those VLBWI who had an adverse cognitive prognosis compared to those with good cognitive prognosis (mean difference in TBV between prognostic groups from 4.56 cm<jats:sup>3<\/jats:sup> at 28\u00a0weeks to 42.58 cm<jats:sup>3<\/jats:sup> at 43\u00a0weeks) as well as in those with adverse language prognosis (mean difference in TBV from 2.21 cm<jats:sup>3<\/jats:sup> at 28\u00a0weeks to 26.98 cm<jats:sup>3<\/jats:sup> at 43\u00a0weeks) although other variables showed more impact than TBV on language prognosis (gestational age at birth, brain injury at term, and socioeconomic status). No association was found between TBV and motor prognosis. Brain growth rate was also significantly higher in those VLBWI who presented good cognitive scores (18.78\u2009+\u2009(0.33\u2009\u00d7\u2009(PMA-33)) cm<jats:sup>3<\/jats:sup>\/week) compared to those with adverse cognitive outcome (13.73\u2009+\u2009(0.64\u2009\u00d7\u2009(PMA-33)) cm<jats:sup>3<\/jats:sup>\/week).<\/jats:p><jats:p><jats:italic>\u00a0 Conclusion<\/jats:italic>: Early altered brain growth is associated with poor cognitive prognosis at 2\u00a0years of age. Using sequential US monitoring, we can detect early brain growth deviation in patients who will have adverse cognitive outcomes.\n<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is known:<\/jats:bold><jats:italic>\u2022 The prediction of neurodevelopmental outcome of\u00a0VLBWI is mostly\u00a0based on the presence of brain injury in US and structural magnetic resonance imaging (MRI) at term. <\/jats:italic><jats:italic>\u2022 Some studies have related brain\u00a0volume measured on MRI at term with neurodevelopment outcome.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is new:<\/jats:bold><jats:italic>\u2022 VLBWI with adverse cognitive prognosis at two years of age present smaller brain volumes detectable by sequential US during NICU admission.<\/jats:italic><jats:italic>\u2022 Brain volume can be estimated from 2D and 3D\u00a0US and\u00a0has prognostic value in VLBWI.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-023-05170-2","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T12:02:35Z","timestamp":1694174555000},"page":"5119-5129","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Relationship of early brain growth pattern measured by ultrasound with neurological outcome at two years of age in very low birth weight infants"],"prefix":"10.1007","volume":"182","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1954-8327","authenticated-orcid":false,"given":"Estefan\u00eda","family":"Ruiz-Gonz\u00e1lez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2937-778X","authenticated-orcid":false,"given":"Sim\u00f3n P.","family":"Lubi\u00e1n-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8781-6464","authenticated-orcid":false,"given":"Natalia","family":"Jim\u00e9nez Luque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7668-5665","authenticated-orcid":false,"given":"Antonio","family":"Segado-Arenas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3970-3833","authenticated-orcid":false,"given":"Manuel","family":"Lubi\u00e1n-Guti\u00e9rrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7520-0854","authenticated-orcid":false,"given":"Yolanda Mar\u00edn","family":"Almagro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6327-3047","authenticated-orcid":false,"given":"Pamela","family":"Zafra-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2736-5109","authenticated-orcid":false,"given":"Paula","family":"M\u00e9ndez-Abad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9276-1912","authenticated-orcid":false,"given":"Isabel","family":"Benavente-Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,8]]},"reference":[{"key":"5170_CR1","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1007\/s11910-018-0862-2","volume":"18","author":"MA Ream","year":"2018","unstructured":"Ream MA, Lehwald L (2018) Neurologic consequences of preterm birth. 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