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Assessment of gestational age and neuromaturation
1Department of Pediatrics, Eudowood Division of Neonatology, The Johns Hopkins School of Medicine, Baltimore, Maryland 21287-3200, USA. mcallen@jhmi.edu
Summary
Neuromaturation, the central nervous system's (CNS) functional development, is a dynamic process influenced by genetics and environment. Measuring it is key for infant neurodevelopmental assessment and identifying at-risk infants.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatrics
Background:
- Neuromaturation is the functional development of the central nervous system (CNS), a dynamic process involving gene-environment interactions.
- Accurate assessment of neuromaturation is fundamental for infant neurodevelopmental evaluation.
- Advances in prenatal ultrasonography and neonatal intensive care units have improved the observation of fetal and preterm neuromaturation.
Purpose of the Study:
- To highlight the importance of understanding and measuring neuromaturation for infant neurodevelopmental assessment.
- To discuss the development and use of measures for fetal maturation and gestational age estimation.
- To explore the impact of pregnancy complications on fetal CNS maturation and potential long-term cognitive effects.
Main Methods:
- Utilizing prenatal ultrasonography and neonatal intensive care unit observations to assess fetal and preterm neuromaturation.
- Developing and employing various measures to estimate gestational age (GA) based on fetal maturation.
- Observing neuromaturation patterns in infants from complicated pregnancies, including intrauterine growth restriction, multiple gestation, and chronic hypertension.
Main Results:
- Prenatal measures are the most reliable for estimating gestational age (GA).
- Stressed pregnancies can accelerate fetal pulmonary and CNS maturation after 30 weeks' gestation, but this may lead to cognitive limitations in childhood.
- Measures of neuromaturation can identify infants at risk, guide follow-up, and provide insights into CNS injury and recovery.
Conclusions:
- Measuring neuromaturation is crucial for assessing neurodevelopmental progress in infants.
- It aids in reassuring parents, identifying at-risk infants for early intervention, and understanding CNS injury/recovery mechanisms.
- Neuromaturation assessment offers valuable early feedback for treatment trials and research on CNS structure-function relationships.