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Neuroimaging Findings and Risk Factors for Brain Injury in Foetuses Treated for Anaemia
Laurence Sophie Carmant1,2, Carlos Robles2,3, Seungwoo Lee4
1Ontario Foetal Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.
Prenatal Diagnosis
|May 10, 2026
Summary
Neuroimaging revealed frequent and varied brain injuries in fetuses with anemia treated with intrauterine transfusions (IUT). Male fetuses were more likely to experience brain injury, highlighting the need for further research.
Area of Science:
- Neuroimaging
- Fetal Medicine
- Pediatric Neurology
Background:
- Fetal anemia is a serious condition requiring intervention.
- Intrauterine transfusion (IUT) is a common treatment for severe fetal anemia.
- Neurodevelopmental outcomes in fetuses with anemia are not well understood.
Purpose of the Study:
- To characterize neuroimaging findings in fetuses diagnosed with anemia.
- To identify risk factors associated with brain injury in these fetuses.
- To evaluate the relationship between anemia severity and brain injury.
Main Methods:
- Retrospective cohort study of pregnancies with fetal anemia treated with IUT.
- Review of prenatal and/or postnatal neuroimaging findings and perinatal outcomes.
- Multivariable logistic regression to identify factors associated with brain injury.
Main Results:
- 52% of eligible fetuses (n=93) showed brain injuries, including intracranial hemorrhage and ischemia.
- Male sex was independently associated with a higher risk of brain injury (aOR 5.04).
- Anemia severity, hydrops, cardiac dysfunction, and gestational age at diagnosis were not associated with brain injury.
Conclusions:
- Brain injuries are common and diverse in fetuses with anemia undergoing IUT.
- Male sex is a significant risk factor for brain injury in this cohort.
- Prospective studies are needed to establish true risks and identify subgroups benefiting from surveillance.
