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The developmental outcome of children with antenatal mild isolated ventriculomegaly
S L Bloom1, D D Bloom, C DellaNebbia
1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, USA. sbloom@mednet.swmed.edu
Insights
Infants with mild isolated ventriculomegaly diagnosed by ultrasound show developmental delays. Early identification through prenatal sonography can target children for crucial early intervention services.
Area of Science:
- Neurodevelopmental Pediatrics
- Prenatal Diagnostics
- Pediatric Neurology
Background:
- Mild isolated ventriculomegaly (IVM) is a common finding on prenatal ultrasound.
- The long-term developmental outcomes for children with isolated IVM are not fully understood.
- Accurate identification of developmental risks is crucial for timely intervention.
Purpose of the Study:
- To assess the standardized developmental test performance of children diagnosed with mild isolated IVM prenatally.
- To determine if prenatal diagnosis of mild isolated IVM is associated with developmental delays.
- To evaluate the utility of antepartum sonography in identifying infants needing early intervention.
Main Methods:
- Retrospective search of ultrasound records (1990-1996) for mild isolated IVM.
- Matched case-control study comparing children with IVM to unaffected peers.
- Standardized developmental testing (Bayley Scales, Vineland Scales) by blinded examiners.
Main Results:
- Children with IVM scored significantly lower on mental (P=.017) and psychomotor (P=.039) development indices.
- Eight IVM children (36%) had developmental delay in mental index vs. one control (P=.021).
- Adaptive behavior skills were not significantly different between groups (P=.571).
Conclusions:
- Mild isolated IVM detected prenatally is linked to a significant risk of developmental delay.
- Findings highlight the value of antepartum sonography for identifying at-risk infants.
- Early identification enables targeted intervention for improved developmental outcomes.
Objective:
To evaluate standardized developmental test performance of infants and children who as fetuses had mild isolated cerebral ventriculomegaly diagnosed by ultrasound.
Methods:
Ultrasound records from 1990 to 1996 were searched for cases of mild isolated ventriculomegaly, and standardized developmental testing of the children was offered to their parents. Each consented child was matched to a normal antepartum subject with respect to sex, race, indication for ultrasound, and gestational age (+/- 2 weeks) at the time of ultrasound. Tests of cognitive, motor, and adaptive behavior were then administered by examiners blinded to the subjects' case or comparison status.
Results:
Twenty-two cases and an equal number of matched comparison subjects completed the testing. The ventriculomegaly and comparison groups were similar with respect to parental age, maternal education, and household income. The ventriculomegaly subjects scored significantly lower than the comparison group on both the Bayley Scales of Infant Development: mental development index (88.95 versus 99.68, P = .017) and psychomotor development index (95.99 versus 103.95, P = .039). Eight of the 22 ventriculomegaly children were classified as developmentally delayed on the mental developmental index compared with one of 22 children in the comparison group (P = .021). Adaptive behavior skills, as measured by the Vineland Behavior Scales (99.64 versus 102.68), were not significantly different between the groups (P = .571).
Conclusion:
Mild isolated ventriculomegaly detected on antepartum sonographic examination is associated with a significant risk for developmental delay. Insofar as these children were judged to be completely normal at birth, our findings represent an important application of antepartum sonography for identifying infants who could be targeted for early childhood intervention.