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Brain volumes and white matter microstructure in 8- to 10-year-old children born with fetal growth restriction
Noora Korkalainen1,2, Tero Ilvesmäki3,4, Riitta Parkkola3,4
1Department of Obstetrics and Gynecology, PEDEGO Research Unit, Oulu University Hospital, Aapistie 5 A, 5000, FI-90014, Oulu, PL, Finland. noora.korkalainen@hus.fi.
Insights
Children born with fetal growth restriction show altered white matter microstructure by early school age, even without differences in brain volume. This suggests poor fetal growth impacts brain development and may lead to neurodevelopmental issues.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatric Imaging
Background:
- Placental insufficiency leading to fetal growth restriction (FGR) is linked to neurodevelopmental risks.
- Chronic hypoxemia in FGR can affect brain organization and maturation.
Purpose of the Study:
- To evaluate the impact of FGR and fetal hemodynamic abnormalities on brain volumes and white matter microstructure.
- To assess neurodevelopmental outcomes at early school age in children with FGR.
Main Methods:
- Magnetic resonance imaging (MRI) was used to examine 32 children with FGR and 27 controls at 8-10 years of age.
- Analysis included cerebral volumes, tract-based spatial statistics, and atlas-based white matter analysis.
Main Results:
- Children with FGR had smaller intracranial volumes but similar grey and white matter volumes compared to controls.
- White matter analysis revealed higher mean and radial diffusivity in large tracts for children with FGR.
Conclusions:
- Fetal growth restriction is associated with significant white matter microstructure changes by 8-10 years of age.
- These microstructural alterations may contribute to later neurodevelopmental impairments.
Background:
Fetal growth restriction caused by placental insufficiency is associated with increased risk of poor neurodevelopment, even in the absence of specific perinatal brain injury. Placental insufficiency leads to chronic hypoxaemia that may alter cerebral tissue organisation and maturation.
Objective:
The aim of this study was to assess the effects fetal growth restriction and fetal haemodynamic abnormalities have on brain volumes and white matter microstructure at early school age.
Materials And Methods:
This study examined 32 children born with fetal growth restriction at 24 to 40 gestational weeks, and 27 gestational age-matched children, who were appropriate for gestational age. All children underwent magnetic resonance imaging (MRI) at the age of 8-10 years. Cerebral volumes were analysed, and tract-based spatial statistics and atlas-based analysis of white matter were performed on 17 children born with fetal growth restriction and 14 children with birth weight appropriate for gestational age.
Results:
Children born with fetal growth restriction demonstrated smaller total intracranial volumes compared to children with normal fetal growth, whereas no significant differences in grey or white matter volumes were detected. On atlas-based analysis of white matter, children born with fetal growth restriction demonstrated higher mean and radial diffusivity values in large white matter tracts when compared to children with normal fetal growth.
Conclusion:
Children ages 8-10 years old born with fetal growth restriction demonstrated significant changes in white matter microstructure compared to children who were appropriate for gestational age, even though no differences in grey and white matter volumes were detected. Poor fetal growth may impact white matter maturation and lead to neurodevelopmental impairment later in life.
