Category: Ultrasound/Imaging
Poster Session I
Fetal insula development appeared to be altered by growth restriction. We aim 1) to compare insular measurements between fetuses with fetal growth restriction (FGR) versus small for gestational age (SGA) and 2) to evaluate the association of insular measurements and neurodevelopmental outcomes.
Study Design: This was a cohort study of singleton non-anomalous pregnancies with estimated fetal weight < 10th centile diagnosed at 29-36 weeks. Using data from the last examination prior to delivery fetal insular depth, sylvian fissure depth, hypoechoic insular zone thickness (HIZT), circumference (HIZC), and area (HIZA) were measured as shown in figure 1. All measurements were adjusted for head circumference. Neurodevelopmental outcomes were evaluated between 2-3 years of age using the Bayley-III scales adjusting for delivery gestational age (GA). Mann-Whitney U was used to compare insular measurements between FGR vs. SGA. Spearman’s Rho correlation was used to evaluate the relationship of insular measurements with the summation percentile of the Bayley-III scales and for each of the scale.
Results:
A total of 68 pregnancies were included in the study (FGR n=39, SGA n=29) and Bayley-III result was available for 29 cases. The GA at analysis was similar between FGR and SGA groups (34.7 vs. 35.2 weeks, p:0.57). There were no differences of insular measurements among SGA vs. FGR fetuses (Figure 2a). Insular depth, sylvian fissure depth, HIZT and HIZA were not correlated with neurodevelopmental outcomes (Figure 2b). HIZC was inversely correlated with the summative percentile of the Bayley-III scales, language and adaptive behavior scales (Figure 2c, d and e).
Conclusion:
In our cohort, no difference was seen in insular measurements among FGR vs. SGA groups. However, fetal HIZC appeared to be inversely correlated with neurodevelopmental outcomes in early childhood. We speculate that enlargement of HIZC may be an indication of accelerated neuronal maturation in late onset growth restricted fetuses with mild hypoxia.
Manesha Putra, MD (he/him/his)
University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
Emma E. Peek, BS (she/her/hers)
University of Colorado Anschutz Medical Campus
Denver, Colorado, United States
John Hobbins, MD
University of Colorado
Aurora, Colorado, United States