Department of Obstetrics and Gynecology, PEDEGO Research Unit, Oulu University Hospital, Aapistie 5 A, 5000, FI-90014, Oulu, PL, Finland.
University of Oulu, Oulu, Finland.
Pediatr Radiol. 2022 Nov;52(12):2388-2400. doi: 10.1007/s00247-022-05372-0. Epub 2022 Apr 22.
Fetal growth restriction caused by placental insufficiency is associated with increased risk of poor neurodevelopment, even in the absence of specific perinatal brain injury. Placental insufficiency leads to chronic hypoxaemia that may alter cerebral tissue organisation and maturation.
The aim of this study was to assess the effects fetal growth restriction and fetal haemodynamic abnormalities have on brain volumes and white matter microstructure at early school age.
This study examined 32 children born with fetal growth restriction at 24 to 40 gestational weeks, and 27 gestational age-matched children, who were appropriate for gestational age. All children underwent magnetic resonance imaging (MRI) at the age of 8-10 years. Cerebral volumes were analysed, and tract-based spatial statistics and atlas-based analysis of white matter were performed on 17 children born with fetal growth restriction and 14 children with birth weight appropriate for gestational age.
Children born with fetal growth restriction demonstrated smaller total intracranial volumes compared to children with normal fetal growth, whereas no significant differences in grey or white matter volumes were detected. On atlas-based analysis of white matter, children born with fetal growth restriction demonstrated higher mean and radial diffusivity values in large white matter tracts when compared to children with normal fetal growth.
Children ages 8-10 years old born with fetal growth restriction demonstrated significant changes in white matter microstructure compared to children who were appropriate for gestational age, even though no differences in grey and white matter volumes were detected. Poor fetal growth may impact white matter maturation and lead to neurodevelopmental impairment later in life.
胎盘功能不全导致的胎儿生长受限与神经发育不良的风险增加有关，即使没有特定的围产期脑损伤也是如此。胎盘功能不全导致慢性低氧血症，可能改变脑组织的组织和成熟。
本研究旨在评估胎儿生长受限和胎儿血液动力学异常对早期学龄期脑容量和白质微观结构的影响。
本研究检查了 32 名在 24 至 40 孕周时患有胎儿生长受限的儿童和 27 名胎龄匹配的适当胎龄儿童。所有儿童在 8-10 岁时进行磁共振成像（MRI）检查。分析脑容量，并对 17 名患有胎儿生长受限和 14 名出生体重适当的儿童进行基于图谱的白质分析。
与正常胎儿生长的儿童相比，患有胎儿生长受限的儿童总颅内体积较小，而灰质或白质体积无显著差异。在基于图谱的白质分析中，与正常胎儿生长的儿童相比，患有胎儿生长受限的儿童在大的白质束中表现出更高的平均和放射状扩散系数值。
与胎龄适当的儿童相比，8-10 岁患有胎儿生长受限的儿童的白质微观结构发生了显著变化，尽管灰质和白质体积没有差异。胎儿生长不良可能会影响白质成熟，并导致日后的神经发育障碍。
