Echogenicity changes in the fetal brain, a 6-year follow-up study.
OBJECTIVE
To asses the relation between echogenicity changes in the fetal brain and neurodevelopmental outcome until 6 years of age.


METHODS
Fetuses (n = 124) from pregnancies affected by hypertensive disorders (n = 64) or preterm labor (n = 60) at risk for preterm birth (26-34 weeks gestation) were studied. Moderate echogenicity changes (periventricular grade IB, II; intraventricular grade II-III; local basal ganglia/thalami) in the fetal and neonatal brain were related to neurological outcome and Griffiths mental developmental scales quotients at 1, 2 and 6 years. Multiple regression analysis tested the influence of moderate echogenicity changes and perinatal clinical characteristics on composite outcome (death or abnormal neurodevelopment).


RESULTS
Moderate echogenicity changes were present in 37/124 (30%) fetuses. Median gestational age and weight at birth were respectively 31 weeks (range 26-43), 1314 g (range 550-4330), mortality was 19%, follow-up loss 10%. Composite outcome was abnormal in 47/124 (38%). Fetal and neonatal moderate intraventricular echodensities were related to cerebral palsy at 6 years (p < 0.04). In the multiple regression analysis only gestational age was related to composite outcome (p = 0.005).


CONCLUSIONS
Moderate intraventricular echodensities in the fetal brain related to cerebral palsy at 6 years of age. Gestational age at birth was the main predictor of abnormal composite outcome.
Department of Obstetrics and Gynecology, Research Institute MOVE, VU University Medical Centre, Amsterdam, the Netherlands. fleur.rosier@inter.nl.net
F M F
FM
Rosier-van Dunné
G
G
van Wezel-Meijler
L
L
de Groot
J I
JI
van Zyl
H J
HJ
Odendaal
J I P
JI
de Vries
D000328:Adult; D001921:Brain / Q000002:abnormalities* / Q000196:embryology; D002547:Cerebral Palsy / Q000000981:diagnostic imaging; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D004453:Echoencephalography; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000000981:diagnostic imaging / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000000981:diagnostic imaging / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D011247:Pregnancy; D016216:Ultrasonography, Prenatal