Department of Perinatology and Gynecology, Kagawa University Graduate School of Medicine, Miki, Kagawa, Japan.
J Perinat Med. 2019 May 27;47(4):429-433. doi: 10.1515/jpm-2018-0379.
Objective To assess whether neurological maturation and development are accelerated in fetal growth restriction (FGR) in utero using four-dimensional (4D) ultrasound. Methods The facial expressions of 50 appropriate-for-gestational-age (AGA) and 34 FGR fetuses aged between 28 and 35 gestational weeks were assessed using 4D ultrasound. Subsequently, they were differentiated into two gestational age groups (19 aged 28-31 weeks and 31 aged 32-35 weeks in AGA, and 15 aged 28-31 weeks and 19 aged 32-35 weeks in FGR). Fifteen-minute recordings were made, and the frequencies of seven facial expressions during that time were examined. Correlation analysis was conducted to assess the changing number of significant correlations with advancing gestation in each group. Results Out of 21 combinations of facial expressions at 28-31 and 32-35 gestational weeks in AGA fetuses, there was only three significant correlations. Similarly, only one was noted out of 21 combinations at 28-31 gestational weeks, but there were seven significant correlations in FGR fetuses at 32-35 weeks (P=0.018). However, there was no significant difference in the number of correlations of facial expressions between AGA (3/21) and FGR (7/21) fetuses at 32-35 weeks of gestation (P=0.147). Conclusion Our results suggest that the number of significant correlations of fetal facial expressions in FGR fetuses increases more compared with that in AGA fetuses at 32-35 weeks of gestation. Due to the acceleration of neurological maturation and development in FGR fetuses, the control of facial expressions by the brain may be more evident compared with AGA fetuses at 32-35 weeks of gestation. However, the data and their interpretation in the present study should be taken with some degree of caution because of the small number of subjects studied. Further studies involving a larger sample size are needed to obtain strong or additional evidence.
利用四维（4D）超声评估宫内胎儿生长受限（FGR）是否加速了神经成熟和发育。
对 50 例胎龄适当（AGA）和 34 例 FGR 胎儿在 28 至 35 孕周时的面部表情进行 4D 超声评估。随后，将其分为两个胎龄组（AGA 中 19 例为 28-31 周龄，31 例为 32-35 周龄，FGR 中 15 例为 28-31 周龄，19 例为 32-35 周龄）。记录 15 分钟，检查这段时间内 7 种面部表情的出现频率。进行相关分析，以评估每组随着孕周的推进，显著相关的数量变化。
在 AGA 胎儿 28-31 周和 32-35 周的 21 种面部表情组合中，仅有 3 种存在显著相关性。同样，在 28-31 周龄的 21 种组合中仅观察到 1 种，而在 32-35 周龄的 FGR 胎儿中则有 7 种存在显著相关性（P=0.018）。然而，在 32-35 孕周，AGA（3/21）和 FGR（7/21）胎儿的面部表情相关性数量无显著差异（P=0.147）。
我们的结果表明，与 AGA 胎儿相比，FGR 胎儿在 32-35 孕周时，胎儿面部表情的显著相关性数量增加更多。由于 FGR 胎儿的神经成熟和发育加速，与 32-35 孕周的 AGA 胎儿相比，大脑对面部表情的控制可能更加明显。然而，由于研究对象数量较少，应谨慎对待本研究的数据及其解释。需要进一步进行涉及更大样本量的研究，以获得更有力或额外的证据。
