Background <p>There are few studies on the brain structure of preterm infants based on low-grade intraventricular hemorrhage. The purpose of this study was to report changes in total and regional brain structure abnormalities in preterm neonates (PN) with low-grade intraventricular hemorrhage (grades I and II) and no other associated MRI abnormalities, and to correlate these changes with gestational age (GA).</p> Methods <p>We examined 76 preterm neonates (26 with low-grade IVH and 50 without IVH) who showed no focal abnormalities on magnetic resonance imaging (MRI) at term-equivalent age. The structural assessment of the brain involves measuring the surface area, thickness, average curvature, and volume of different regions. Retrospective analysis of brain magnetic resonance images of 25 healthy full-term infants and comparison with premature newborns, whose age after postmenstrual was similar.</p> Results <p>Compared with the control preterm infants, the infants with low-grade IVH had decreases in the following:1) Total brain surface area;2) the surface area in Orbitofrontal-Med Right; 3) brain volume in Right Orbitofrontal-Med and Right Hippocampus and Right Thalamus.</p> Conclusions <p>Our study reveals the potential harmful effects of low-grade IVH on surface area and volume development in preterm infants compared to those without IVH at term-equivalent age, underscoring its clinical significance for neurodevelopment in infants with low-grade IVH.</p>