Echogenicity changes in the fetal brain, a 6-year follow-up study
F M F Rosier-van Dunné1, G van Wezel-Meijler, L de Groot
1Department of Obstetrics and Gynecology, Research Institute MOVE, VU University Medical Centre, Amsterdam, the Netherlands. fleur.rosier@inter.nl.net
Summary
Fetal brain echogenicity changes, particularly moderate intraventricular echodensities, are linked to cerebral palsy in children. However, gestational age at birth remains the primary predictor of overall neurodevelopmental outcomes.
Area of Science:
- Neonatal neurology
- Fetal imaging
- Developmental pediatrics
Background:
- Hypertensive disorders and preterm labor in pregnancy increase the risk of preterm birth.
- Preterm birth is associated with adverse neurodevelopmental outcomes.
- Fetal brain echogenicity changes on ultrasound may indicate neurological risk.
Purpose of the Study:
- To assess the relationship between fetal brain echogenicity changes and neurodevelopmental outcomes up to age 6.
- To identify predictors of adverse neurodevelopmental outcomes in high-risk preterm infants.
Main Methods:
- Studied 124 fetuses from pregnancies with hypertensive disorders or preterm labor, at risk for preterm birth (26-34 weeks gestation).
- Assessed moderate echogenicity changes (periventricular, intraventricular, basal ganglia/thalami) in fetal and neonatal brains.
- Related echogenicity to neurological outcome and Griffiths mental developmental scales at 1, 2, and 6 years using multiple regression analysis.
Main Results:
- Moderate echogenicity changes were observed in 30% of fetuses.
- Intraventricular echodensities correlated with cerebral palsy at 6 years (p < 0.04).
- Gestational age at birth was the only significant predictor of composite outcome (p = 0.005).
Conclusions:
- Moderate intraventricular echodensities in the fetal brain are associated with cerebral palsy at 6 years.
- Gestational age at birth is the most critical factor for predicting adverse neurodevelopmental outcomes in this cohort.
