title: Functional brain development in growth-restricted and constitutionally small fetuses: a fetal magnetoencephalography case-control study.
abstract: OBJECTIVE
  Fetal magnetoencephalography records fetal brain activity non-invasively. Delayed brain responses were reported for fetuses weighing below the tenth percentile. To investigate whether this delay indicates delayed brain maturation resulting from placental insufficiency, this study distinguished two groups of fetuses below the tenth percentile: growth-restricted fetuses with abnormal umbilical artery Doppler velocity (IUGR) and constitutionally small-for-gestational-age fetuses with normal umbilical artery Doppler findings (SGA) were compared with fetuses of adequate weight for gestational age (AGA), matched for age and behavioural state.
  
  
  METHODS
  A case-control study of matched pairs.
  
  
  METHODS
  Fetal magnetoencephalography-Center at the University Hospital of Tuebingen.
  
  
  METHODS
  Fourteen IUGR fetuses and 23 SGA fetuses were matched for gestational age and fetal behavioural state with 37 healthy, normal-sized fetuses.
  
  
  METHODS
  A 156-channel fetal magentoencephalography system was used to record fetal brain activity. Light flashes as visual stimulation were applied to the fetus. The Student's t-test for paired groups was performed.
  
  
  METHODS
  Latency of fetal visual evoked magnetic responses (VER).
  
  
  RESULTS
  The IUGR fetuses showed delayed VERs compared with controls (IUGR, 233.1 ms; controls, 184.6 ms; P = 0.032). SGA fetuses had similar evoked response latencies compared with controls (SGA, 216.1 ms; controls, 219.9 ms; P = 0.828). Behavioural states were similarly distributed.
  
  
  CONCLUSIONS
  Visual evoked responses are delayed in IUGR fetuses, but not in SGA. Fetal behavioural state as an influencing factor of brain response latency was accounted for in the comparison. This reinforces that delayed brain maturation is the result of placental insufficiency.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Tuebingen, Tuebingen, Germany.|fMEG-Center, University of Tuebingen, Tuebingen, Germany.
authors.forename: E C
authors.initials: EC
authors.lastname: Morin
authors.affiliation: fMEG-Center, University of Tuebingen, Tuebingen, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Schleger
authors.affiliation: fMEG-Center, University of Tuebingen, Tuebingen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Preissl
authors.affiliation: Department of Obstetrics and Gynaecology, University of Tuebingen, Tuebingen, Germany.|fMEG-Center, University of Tuebingen, Tuebingen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Braendle
authors.affiliation: SARA Research Center, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: H
authors.initials: H
authors.lastname: Eswaran
authors.affiliation: Department of Obstetrics and Gynaecology, University of Tuebingen, Tuebingen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Abele
authors.affiliation: Department of Obstetrics and Gynaecology, University of Tuebingen, Tuebingen, Germany.|University Women's Hospital and Research Institute for Women's Health, Tuebingen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Brucker
authors.affiliation: Department of Obstetrics and Gynaecology, University of Tuebingen, Tuebingen, Germany.|fMEG-Center, University of Tuebingen, Tuebingen, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Kiefer-Schmidt
mesh_terms: D001034:Apgar Score; D001783:Blood Flow Velocity; D001921:Brain / Q000196:embryology / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D047109:Fetal Development; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005333:Fetus / Q000098:blood supply*; D005858:Germany; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D015225:Magnetoencephalography; D008297:Male; D016555:Matched-Pair Analysis; D010927:Placental Insufficiency / Q000503:physiopathology*; D011247:Pregnancy; D018608:Ultrasonography, Doppler; D014469:Umbilical Arteries / Q000000981:diagnostic imaging
keywords: Fetal behavioural state; fetal brain development; fetal magnetoencephalography; intrauterine growth restriction; visual evoked response