Association of biparietal diameter growth rate with neurodevelopment in infants with fetal growth restriction

Area of Science:

• Perinatology
• Fetal Medicine
• Neurodevelopmental Pediatrics

Background:

• Severe fetal growth restriction (FGR) poses significant risks to infant neurodevelopment.
• Biparietal diameter (BPD) is a key biometric parameter used in fetal assessment.
• Understanding the relationship between BPD growth patterns and neurodevelopmental outcomes is critical for early intervention.

Purpose of the Study:

• To investigate the association between biparietal diameter (BPD) growth rate and neurodevelopmental complications in infants with severe fetal growth restriction.
• To identify BPD growth delay as a potential risk factor for adverse neurodevelopmental outcomes.

Main Methods:

• Retrospective analysis of pregnant women with severe FGR (<5th percentile) before 30 weeks gestation.
• Definition of poor BPD growth: at least 50% below mean growth rate for at least 1 week.
• Assessment of neonatal morbidities, perinatal mortality, and neurodevelopmental complications at 2 years corrected age.

Main Results:

• Out of 8254 infants, 26 met criteria for severe FGR; 17 had poor BPD growth, 9 had normal BPD growth.
• No significant difference in gestational age at delivery between groups.
• Eight infants (47%) in the poor BPD growth group experienced death or neurodevelopmental complications, versus none in the normal BPD growth group (p=0.009).

Conclusions:

• BPD growth rate is significantly associated with neurodevelopmental outcomes in infants with severe FGR.
• Growth delay in BPD, compared to the mean growth rate, is a risk factor for poor neurodevelopmental outcomes.
• This highlights the importance of monitoring fetal growth parameters for predicting neurodevelopmental trajectories.