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Neurodevelopmental outcomes in mild and moderate isolated ventriculomegaly originating in utero
Guoyu Sun1, Baihua Jing2, Faliang Zhou1
1Department of Pediatrics, Peking University First Hospital, Beijing, China.
Insights
Mild and moderate isolated ventriculomegaly (IVM) showed similar neurodevelopmental outcomes at 12 months. However, intrauterine progression of ventriculomegaly is a significant predictor of poorer neurodevelopmental outcomes in fetuses with IVM.
Area of Science:
- Perinatology
- Developmental Neuroscience
- Pediatric Neurology
Background:
- Isolated ventriculomegaly (IVM) is a common finding in fetal ultrasounds.
- Understanding the neurodevelopmental outcomes associated with mild versus moderate IVM is crucial for clinical management.
Purpose of the Study:
- To compare neurodevelopmental outcomes between fetuses with mild and moderate isolated ventriculomegaly.
- To identify prognostic factors for neurodevelopmental impairment in IVM.
Main Methods:
- A prospective cohort study of 94 fetuses with IVM.
- Neurodevelopmental assessment at 12 months using ASQ-3 and BSID-I.
- Classification of IVM into mild (10-12 mm) and moderate (12.1-15 mm) groups.
- Evaluation of in utero ventriculomegaly progression.
Main Results:
- No significant difference in neurodevelopmental impairment (NDI) rates between mild and moderate IVM groups (p=0.155).
- Fetuses with in utero progression of ventriculomegaly had a significantly higher NDI rate (33.3%) compared to those without progression (7.6%, p=0.004).
- Maximum change in atrial diameter during gestation, not maximum diameter, negatively correlated with psychomotor and mental development index scores.
Conclusions:
- Mild and moderate isolated ventriculomegaly likely do not differ in their neurodevelopmental outcomes.
- Intrauterine progression of ventriculomegaly is a potential indicator of adverse neurodevelopmental outcomes.
Objective:
To determine the differences in outcomes between mild and moderate isolated ventriculomegaly (IVM).
Methods:
We conducted a prospective cohort study on 94 fetuses with IVM and evaluated the neurodevelopmental outcomes at 12 months of age using the ASQ-3 and BSID-I neurodevelopmental assessment tools. Progression of VM was defined as an increase in the width of the ventricular by at least 3 mm during sequential ultrasound monitoring. The population was divided into two groups according to ventricular width: mild (10-12 mm) and moderate (12.1-15 mm), which were further evaluated for VM progression in utero separately.
Results:
Neurodevelopmental assessments at 12 months were the main form of evaluations. Neurodevelopmental impairment (NDI) was defined as a mental development index (MDI) or psychomotor development index (PDI) < 85. There were no significant differences in NDI values between the mild and moderate groups (p = .155). Compared with the non-in utero progression group (7.6%), the rate of NDI was significantly higher (p = .004) in the group with progression (33.3%). Using linear regression and correlation, no negative correlation was found between the maximum value of atrial diameter (AD) in utero and the PDI (r = -0.021, p = .914) or MDI (r = -0.073, p = .703) score. However, the maximum change in the AD in utero was negatively correlated with both PDI (r = -0.460, p = .011) and MDI (r=-0.422, p = .020) scores.
Conclusion:
There were likely no differences in neurodevelopmental outcomes between mild and moderate IVM. In fetuses with mild to moderate VM, intrauterine progression may be a poor prognostic factor for neurodevelopmental outcomes.
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