Prenatal detection of impaired corpus callosum growth using two-dimensional neurosonography in growth-restricted fetuses: potential indicator of fetal brain remodeling in-utero
Location
Auditorium Pond Side
Start Date
26-2-2014 10:30 AM
Abstract
Objectives: Fetal corpus callosum (CC) serves as a sensitive indicator for brain development and maturation. This largest white-matter-fiber-bundle is important for inter-hemispheric communication of sensory, motor and higher-order information. Its altered development in preterm-infants suggests white-matter-injury and its possible association with delayed cognitive and motor development. We aim to compare the growth of CC in appropriate-for-gestational-age (AGA) and growth-restricted-fetuses (GRFs) using two-dimensional-neuroimaging.
Methods: 42 pregnant women were examined in the third-trimester (25-37 weeks) from October- December 2013. Inclusion criteria were singleton fetuses with no structural or chromosomal abnormalities and pregnant women with no medical complications. Fetal brain was examined in the mid-sagittal plane. Length of the CC was measured across outer-outer and inner-inner diameters along with its area. Mean of three measurements recorded in millimeters was included in the analysis. Results: Out of 42 fetuses examined, 31 were identified as AGA and 11 as GRFs based on their estimated-fetal-weight. Mid-sagittal view was successfully obtained in all except for 4 AGA fetuses (90%). Mean maternal age, mean gestational age (GA) and mean area of CC did not differ between the groups (p-value > 0.05). Mean outer-outer and mean inner-inner diameters of CC were significantly lower for GRFs [37.12 (S.D. = 4.6) and 31.27 (S.D. = 4)] compared to AGA fetuses [41.2 (S.D. = 3.4) and 35.8 (S.D. = 2.4)] (p-values: 0.006 and 0.001), respectively. However, both the diameters showed a positive correlation with GA in AGA and GRFs.
Conclusions: GRFs show a diminished growth of CC. This may be an indicator of fetal brain remodeling in-utero as an adaptation to compromised intra-uterine environment. Further studies with larger sample size and with inclusion of additional neural biomarkers are needed to validate our findings and to evaluate the effect of reduced fetal CC growth on cognitive and motor development during early childhood.
Keywords: corpus callosum, two-dimensional neurosonography, growth restricted fetuses, brain remodeling
Prenatal detection of impaired corpus callosum growth using two-dimensional neurosonography in growth-restricted fetuses: potential indicator of fetal brain remodeling in-utero
Auditorium Pond Side
Objectives: Fetal corpus callosum (CC) serves as a sensitive indicator for brain development and maturation. This largest white-matter-fiber-bundle is important for inter-hemispheric communication of sensory, motor and higher-order information. Its altered development in preterm-infants suggests white-matter-injury and its possible association with delayed cognitive and motor development. We aim to compare the growth of CC in appropriate-for-gestational-age (AGA) and growth-restricted-fetuses (GRFs) using two-dimensional-neuroimaging.
Methods: 42 pregnant women were examined in the third-trimester (25-37 weeks) from October- December 2013. Inclusion criteria were singleton fetuses with no structural or chromosomal abnormalities and pregnant women with no medical complications. Fetal brain was examined in the mid-sagittal plane. Length of the CC was measured across outer-outer and inner-inner diameters along with its area. Mean of three measurements recorded in millimeters was included in the analysis. Results: Out of 42 fetuses examined, 31 were identified as AGA and 11 as GRFs based on their estimated-fetal-weight. Mid-sagittal view was successfully obtained in all except for 4 AGA fetuses (90%). Mean maternal age, mean gestational age (GA) and mean area of CC did not differ between the groups (p-value > 0.05). Mean outer-outer and mean inner-inner diameters of CC were significantly lower for GRFs [37.12 (S.D. = 4.6) and 31.27 (S.D. = 4)] compared to AGA fetuses [41.2 (S.D. = 3.4) and 35.8 (S.D. = 2.4)] (p-values: 0.006 and 0.001), respectively. However, both the diameters showed a positive correlation with GA in AGA and GRFs.
Conclusions: GRFs show a diminished growth of CC. This may be an indicator of fetal brain remodeling in-utero as an adaptation to compromised intra-uterine environment. Further studies with larger sample size and with inclusion of additional neural biomarkers are needed to validate our findings and to evaluate the effect of reduced fetal CC growth on cognitive and motor development during early childhood.
Keywords: corpus callosum, two-dimensional neurosonography, growth restricted fetuses, brain remodeling