title: Fetal brain magnetic resonance imaging and long-term neurodevelopmental impairment.
abstract: OBJECTIVE
  To determine the incidence of fetal brain injury by fetal brain magnetic resonance imaging (MRI) in pregnancies complicated with preterm labor (PL), preterm premature rupture of the membranes (PPROM), and intrauterine growth restriction (IUGR), and to compare fetal brain MRI with prenatal surveillance methods, and with immediate and long-term neurodevelopmental outcome.
  
  
  METHODS
  Between February 2007 and January 2009, high-risk pregnancies were analyzed by MRI at 1.5 Tesla after 24 weeks of gestation at the Clinical Hospital Center Zagreb, Croatia. Long-term outcome was defined as neurodevelopmental outcome at 24 months.
  
  
  RESULTS
  Among 70 pregnancies analyzed, 40.0% had abnormal fetal brain MRI. The highest incidence occurred in the PL group. There was no correlation between abnormal MRI and fetal surveillance methods (ultrasound, Doppler blood flow analysis, cardiotocography, biophysical profile) or immediate neonatal outcome (1-minute Apgar score, umbilical cord pH). Via MRI, fetal brain injury would have been diagnosed for 45.7% of fetuses with a long-term neurodevelopmental handicap. Binary logistic regression showed that, as compared with other surveillance methods, fetal brain MRI was the best predictor of long-term neurodevelopmental disability.
  
  
  CONCLUSIONS
  PL, IUGR, and PPROM were associated with an early intrauterine CNS insult that was not accurately detected by existing prenatal testing options.
authors.affiliation: Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, School of Medicine, University of Zagreb, Croatia. Electronic address: vladimir.banovic2@zg.t-com.hr.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Banović
authors.affiliation: Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, School of Medicine, University of Zagreb, Croatia.
authors.forename: Snježana
authors.initials: S
authors.lastname: Škrablin
authors.affiliation: Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, School of Medicine, University of Zagreb, Croatia.
authors.forename: Maja
authors.initials: M
authors.lastname: Banović
authors.affiliation: Department of Radiology, Clinical Hospital Center Zagreb, School of Medicine, University of Zagreb, Croatia.
authors.forename: Marko
authors.initials: M
authors.lastname: Radoš
authors.affiliation: Department of Neonatology, Clinical Hospital Center Zagreb, School of Medicine, University of Zagreb, Croatia.
authors.forename: Snježana
authors.initials: S
authors.lastname: Gverić-Ahmetašević
authors.affiliation: Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, School of Medicine, University of Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Babić
mesh_terms: D001930:Brain Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D002675:Child, Preschool; D017523:Croatia; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology; D005322:Premature Rupture of Fetal Membranes / Q000503:physiopathology; D005333:Fetus / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D007752:Obstetric Labor, Premature / Q000503:physiopathology; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011296:Prenatal Diagnosis / Q000379:methods*; D013997:Time Factors
keywords: Fetal brain injury; Fetal brain magnetic resonance imaging; Long-term neurodevelopmental impairment