Related Experiment Videos
The differences in growth of cerebellar vermis between appropriate-for-gestational-age and small-for-gestational-age
1Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
Insights
Small-for-gestational-age (SGA) infants show cerebellar vermis growth retardation only in late gestation compared to appropriate-for-gestational-age (AGA) infants. Cranial ultrasound measurements of the cerebellar vermis may aid in assessing newborn neurological maturation.
Area of Science:
- Neonatal Neurology
- Fetal Development
- Medical Imaging
Background:
- Intrauterine growth restriction impacts fetal development.
- Cerebellar vermis growth patterns in relation to gestational age are not fully understood.
- Differentiating growth between appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) infants is crucial.
Purpose of the Study:
- To compare cerebellar vermis growth between AGA and SGA neonates.
- To identify the gestational age at which growth differences emerge.
- To evaluate the utility of cerebellar vermis measurements in assessing neurological maturation.
Main Methods:
- Midsagittal cerebral ultrasonography was used to measure cerebellar vermis dimensions (central vermian area, anterior-posterior, and superior-inferior distances) in 218 newborns within 24 hours of birth.
- Infants were categorized as AGA (n=121) or SGA (n=97).
- Exclusion criteria included congenital infections and malformations.
Main Results:
- Second-degree polynomial equations best described the relationship between gestational age and cerebellar vermis measurements in both AGA and SGA groups, with central vermian area showing the strongest correlation with gestational age.
- Significant differences in head circumference were observed between AGA and SGA infants from 34 weeks gestation onwards.
- Significant differences in cerebellar vermis dimensions (central vermian area and superior-inferior distance) were noted only in the 38-41 weeks gestation subgroup, indicating growth retardation primarily in late gestation.
Conclusions:
- Small-for-gestational-age newborns exhibit growth retardation in the cerebellar vermis specifically during late gestation (38-41 weeks) compared to appropriate-for-gestational-age infants.
- Cerebellar vermis measurements via cranial ultrasound show potential for assessing neurological maturation in newborns.
- Further research is recommended to establish normative data and correlate cerebellar vermis size with neurodevelopmental outcomes.
Abstract:
To determine whether there is any difference in the growth of the cerebellar vermis between appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) infants during fetal life, the central vermian area (Cva) of the cerebellum and its anterior-posterior distance (Vap) and superior-inferior distance (Vsi) were measured by midsagittal cerebral ultrasonography in 218 newborns within 24 h of birth. Patients with congenital infections and malformations were excluded. One-hundred twenty-one infants were AGA and 97 SGA. Best curve-fit of second-degree polynominal equations were found between gestational age and Cva, Vap, Vsi in both AGA and SGA neonates. Among them, Cva correlated best with gestational age in both AGA and SGA newborns. Comparing the head circumference (HC), Cva, Vap and Vsi between AGA and SGA neonates in the four gestational age subgroups (24-28, 29-33, 34-37 and 38-41 weeks), significant differences in HC were found in the 34-37 weeks (P < 0.01) and 38-41 weeks (P < 0.001) subgroups. But the significant differences in Cva and Vsi were found only in the 38-41 weeks subgroup. There is more accelerated growth in vermis from 34 to 41 weeks of gestation than that from 24 to 33 weeks. Comparing with AGA, the non-fetal cause of intrauterine growth retarded newborns demonstrate growth retardation in the cerebellar vermis only at late gestation. The cerebellar vermis measured by cranial ultrasound may serve as part of the neurological maturation assessments in newborns. Further work is needed to establish the normogram for the cerebellar vermis in newborns, and to assess the neurodevelopmental outcomes of those with an abnormal vermis.