Association of cranial ultra sonography findings with intrauterine growth restriction in term neonates
DOI:
https://doi.org/10.18203/2349-3291.ijcp20252884Keywords:
Ultrasound sonography, Cranial ultrasound, Fetal growth restriction, Intrauterine growth restrictionAbstract
Background: Fetal growth restriction (FGR) is a condition in which a fetus does not reach its full growth potential in utero. It is a significant contributor to perinatal morbidity and mortality. Cranial ultrasound (CU) is a non-invasive imaging technique used to assess brain structure and abnormalities in neonates, particularly affected by FGR or classified as small for gestational age (SGA). Aim was to determine the association between FGR and CU abnormalities (CUAs) in term neonates.
Methods: It was a single centre, hospital-based, cross-sectional comparative observational study conducted in the level IIIA neonatal intensive care unit (NICU) of Shri Shishu Bhawan Hospital for Children and Newborn, Bilaspur, Chhattisgarh. A total of 194 neonates were selected for the study. Comparative analysis between the FGR and control groups was performed using chi-square tests for categorical variables and t-tests for continuous variables.
Results: The present study observed a higher proportion of CUAs in term neonates with FGR (11.3%) compared to appropriate for gestational age (AGA) neonates 2.06% (p>0.5). Periventricular leukomalacia (PVL) was more commonly observed among FGR neonates (14.3%) compared to AGA neonates 6.18% (p>0.05). The trend suggests that FGR may predispose neonates to a higher risk of periventricular white matter damage, even at term gestation.
Conclusions: FGR has a substantial impact on neonatal brain development and increases the risk of neurodevelopmental complications. Early detection through CU screening and long-term follow-up for neurodevelopmental assessment are essential to improve outcomes in this high-risk population.
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References
Fetal Growth Restriction: ACOG Practice Bulletin, Number 227. Obstet Gynecol. 2021;137(2):e16-28. DOI: https://doi.org/10.1097/AOG.0000000000004251
Hiersch L, Melamed N. Fetal growth velocity and body proportion in the assessment of growth. Am J Obstet Gynecol 2018;218(2S):S700-S711. DOI: https://doi.org/10.1016/j.ajog.2017.12.014
Lees CC, Romero R, Stampalija T, Dall’Asta A, DeVore GA, Prefumo F, et al. Clinical Opinion: The diagnosis and management of suspected fetal growth restriction: an evidence-based approach. Am J Obstet Gynecol. 2022;226(3):366-78. DOI: https://doi.org/10.1016/j.ajog.2021.11.1357
Sacchi C, Marino C, Nosarti C, Vieno A, Visentin S, Simonelli A. Association of Intrauterine Growth Restriction and Small for Gestational Age Status With Childhood Cognitive Outcomes: A Systematic Review and Meta-analysis. JAMA Pediatr. 2020;174(8):772-81. DOI: https://doi.org/10.1001/jamapediatrics.2020.1097
Mileusnić-Milenović R. Higher frequency of germinal matrix-intraventricular hemorrhage in moderate and late preterm and early term neonates with intrauterine growth restriction compared to healthy ones. Acta Clin Croat. 2021;60(4.):651-6. DOI: https://doi.org/10.20471/acc.2021.60.04.12
Yuan J, Cao X, Deng Y. An exploratory study into a new head ultrasound marker for predicting neurodevelopmental outcomes in preterm infants. Ultrasound Quarterly. 2022;38(1):43-8. DOI: https://doi.org/10.1097/RUQ.0000000000000582
Richer EJ, Riedesel EL, Linam LE. Review of neonatal and infant cranial us. Radiographics. 2021;41(7):E206-7. DOI: https://doi.org/10.1148/rg.2021210089
Wezel-Meijler GLV. Cranial ultrasound - optimizing utility in the NICU. Curr Pediatr Rev. 2014;10:16-27. DOI: https://doi.org/10.2174/157339631001140408120106
Oliveira Júnior RE, Teixeira SR, Santana EF, Elias Junior J, Costa FD, Araujo Júnior E, Marcolin AC. Magnetic resonance imaging of skull and brain parameters in fetuses with intrauterine growth restriction. Radiologia Brasileira. 2021;54:141-7. DOI: https://doi.org/10.1590/0100-3984.2020.0025
Caro-Domínguez P, Lecacheux C, Hernandez-Herrera C, Llorens-Salvador R. Cranial ultrasound for beginners. Translat Pediat. 2021;10(4):1117. DOI: https://doi.org/10.21037/tp-20-399
Malhotra A, Ditchfield M, Fahey MC, Castillo-Melendez M, Allison BJ, Polglase GR, et al. Detection and assessment of brain injury in the growth-restricted fetus and neonate. Pediatr Res. 2017;82(2):184-93. DOI: https://doi.org/10.1038/pr.2017.37
Cruz‐Martinez R, Tenorio V, Padilla N, Crispi F, Figueras F, Gratacos E. Risk of ultrasound‐detected neonatal brain abnormalities in intrauterine growth‐restricted fetuses born between 28 and 34 weeks' gestation: relationship with gestational age at birth and fetal Doppler parameters. Ultrasound Obstet Gynecol. 2015;46(4):452-9. DOI: https://doi.org/10.1002/uog.14920
Roufaeil C, Razak A, Malhotra A. Cranial Ultrasound Abnormalities in Small for Gestational Age or Growth-Restricted Infants Born over 32 Weeks Gestation: A Systematic Review and Meta-Analysis. Brain Sci. 2022;12(12):1713. DOI: https://doi.org/10.3390/brainsci12121713
Khazardoost S, Ghotbizadeh F, Sahebdel B, Nasiri Amiri F, Shafaat M, Akbarian-Rad Z, Pahlavan Z. Predictors of cranial ultrasound abnormalities in intrauterine growth-restricted fetuses born between 28 and 34 weeks of gestation: a prospective cohort study. Fetal Diagn Therapy. 2019;45(4):238-47. DOI: https://doi.org/10.1159/000488904
Acharya P, Acharya A. Evaluation of applicability of standard growth curves to Indian women by fetal biometry. JS Asian Fed Obstet Gynecol. 2009;1(3):55-61. DOI: https://doi.org/10.5005/jp-journals-10006-1011