Fetal Brain Biometry and Long-term Neurodevelopmental Outcome
2Department of Obstetrics and Gynecology, Sheba Medical Center, ישראל
3Sackler School of Medicine, Tel-Aviv University, ישראל
4Hadassah Medical School, The Hebrew University of Jerusalem, ישראל
5Department of Diagnostic Radiology, Sheba Medical Center, ישראל
6Department of Obstetrics and Gynecology, Samson Assuta Ashdod Hospital, ישראל
Purpose: Controversial cut-offs for diagnosis of microcephaly and macrocephaly lead to uncertainty regarding long-term prognosis. We assessed the agreement between the clinically used modalities for measuring fetal brain, and the head circumference at birth. We explored the correlation to long-term neurodevelopmental outcome.
Methods: Prospective study conducted between 2011-2019 at a tertiary referral medical center. Microcephaly and macrocephaly were defined as -2 SD and 2SD, respectively. Sonographic head circumference (HC), 2D MRI bi-parietal diameter (BPD) and occipito-frontal diameter (OFD), 3D MRI supra-tentorial volume (STV), and head circumference (HC) at birth were measured and converted into centiles according to gestational age. Spearman`s rank correlation coefficient was used to assess the correlation between the modalities. Neurodevelopmental outcome was evaluated using Vineland II adaptive behavior scales between the ages 2 and 6 years old.
Results: A total of 88 fetuses were included. Mean gestational age at the time of fetal US and brain MRI acquisition were 34.4 ± 2.8 and 34.6 ± 2.6 weeks, respectively. Sonographic HC, OFD on 2D MRI, and STV on 3D MRI were all found to be correlated with the HC at birth (Rs= 0.865, p<0.001; Rs 0.816, p<0.001; Rs= 0.825, p < 0.001, respectively). No significant correlation was found between Vineland scores and the supratentorial brain volume (STV).
Conclusions: There is a statistically significant agreement among the different prenatal clinically used modalities for measuring fetal brain and the HC at birth. When isolated, there is no difference in the long-term neurodevelopmental outcomes in microcephalic and macrocephalic fetuses.
