Sun Guoyu, Jing Baihua, Zhou Faliang, Liu Hongyan, Liu Lili, Chen Junya, Hou Xinlin
Department of Pediatrics, Peking University First Hospital, Beijing, China.
Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, China.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):6691-6698. doi: 10.1080/14767058.2021.1919869. Epub 2021 May 4.
To determine the differences in outcomes between mild and moderate isolated ventriculomegaly (IVM).
We conducted a prospective cohort study on 94 fetuses with IVM and evaluated the neurodevelopmental outcomes at 12 months of age using the ASQ-3 and BSID-I neurodevelopmental assessment tools. Progression of VM was defined as an increase in the width of the ventricular by at least 3 mm during sequential ultrasound monitoring. The population was divided into two groups according to ventricular width: mild (10-12 mm) and moderate (12.1-15 mm), which were further evaluated for VM progression in utero separately.
Neurodevelopmental assessments at 12 months were the main form of evaluations. Neurodevelopmental impairment (NDI) was defined as a mental development index (MDI) or psychomotor development index (PDI) < 85. There were no significant differences in NDI values between the mild and moderate groups ( = .155). Compared with the non- progression group (7.6%), the rate of NDI was significantly higher ( = .004) in the group with progression (33.3%). Using linear regression and correlation, no negative correlation was found between the maximum value of atrial diameter (AD) in utero and the PDI ( = -0.021, = .914) or MDI ( = -0.073, = .703) score. However, the maximum change in the AD in utero was negatively correlated with both PDI ( = -0.460, = .011) and MDI (=-0.422, = .020) scores.
There were likely no differences in neurodevelopmental outcomes between mild and moderate IVM. In fetuses with mild to moderate VM, intrauterine progression may be a poor prognostic factor for neurodevelopmental outcomes.
确定轻度和中度孤立性脑室扩大（IVM）在结局方面的差异。
我们对94例患有IVM的胎儿进行了一项前瞻性队列研究，并使用ASQ - 3和BSID - I神经发育评估工具在12个月大时评估神经发育结局。脑室扩大的进展定义为在连续超声监测期间脑室宽度增加至少3毫米。根据脑室宽度将人群分为两组：轻度（10 - 12毫米）和中度（12.1 - 15毫米），并分别在子宫内进一步评估脑室扩大的进展情况。
12个月时的神经发育评估是主要的评估形式。神经发育障碍（NDI）定义为智力发育指数（MDI）或心理运动发育指数（PDI）< 85。轻度和中度组之间的NDI值无显著差异（P = 0.155）。与无进展组（7.6%）相比，进展组（33.3%）的NDI发生率显著更高（P = 0.004）。使用线性回归和相关性分析，未发现子宫内心房直径（AD）的最大值与PDI（P = -0.021，P = 0.914）或MDI（P = -0.073，P = 0.703）评分之间存在负相关。然而，子宫内AD的最大变化与PDI（P = -0.460，P = 0.011）和MDI（P = -0.422，P = 0.020）评分均呈负相关。
轻度和中度IVM在神经发育结局方面可能没有差异。在轻度至中度脑室扩大的胎儿中，子宫内进展可能是神经发育结局的不良预后因素。
