Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 1;52(4):423-428.
doi: 10.1515/jpm-2023-0487. Print 2024 May 27.

Effects of umbilical vein flow on midbrain growth and cortical development in late onset fetal growth restricted fetuses: a prospective cross-sectional study

Ilenia Mappa  1 , Maria Chiara Marra  1 , Maria Elena Pietrolucci  1 , Jia Li Angela Lu  1 , Francesco D'Antonio  2 , Giuseppe Rizzo  1   2
Affiliations

Effects of umbilical vein flow on midbrain growth and cortical development in late onset fetal growth restricted fetuses: a prospective cross-sectional study

Ilenia Mappa et al. J Perinat Med. .

Abstract

Objectives: To investigate midbrain growth, including corpus callusum (CC) and cerebellar vermis (CV) and cortical development in late fetal growth restricted (FGR) subclassified according to the umbilical vein blood flow (UVBF) values.

Methods: This was a prospective study on singleton fetuses late FGR with abnormal placental cerebral ratio (PCR). FGR fetuses were further subdivided into normal (≥fifth centile) and abnormal (<fifth centile) UVBF blood flow corrected for AC (UVBF/AC), neurosonography was performed at 33-34 weeks of gestation to assess CC and CV lengths and the depth of Sylvian fissure (SF), parieto-occipital (POF) and calcarine fissures (CF). Neurosonographic variables were normalized for fetal head circumference size.

Results: The study cohort included 60 late FGR, 31 with normal UVBF/AC and 29 with abnormal UVBF/AC values. The latter group showed significant differences in CC (median (interquartile range (IQR) normal 0.96 (0.73-1.16) vs. abnormal UVBF/AC 0.60 (0.47-0.87); p<0.0001)), CV (normal 1.04 (0.75-1.26) vs. abnormal UVBF (AC 0.76 (0.62-1.18)); p=0.0319), SF (normal 0.83 (0.74-0.93) vs. abnormal UVBF/AC 0.56 (0.46-0.68); p<0.0001), POF (normal 0.80 (0.71-0.90) vs. abnormal UVBF/AC l 0.49 (0.39-0.90); p≤0.0072) and CF (normal 0.83 (0.56-1.01) vs. abnormal UVBF/AC 0.72 (0.53-0.80); p<0.029).

Conclusions: Late onset FGR fetuses with of reduced umbilical vein flow showed shorter CC and CV length and a delayed cortical development when compared to those with normal umbilical vein hemodynamics. These findings support the existence of a link between abnormal brain development and changes in umbilical vein circulation.

Keywords: cerebellar vermis; corpus callosum; cortical folding; fetal growth restriction; neurosonography; umbilical vein flow.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Arcangeli, T, Thilaganathan, B, Hooper, R, Khan, KS, Bhide, A. Neurodevelopmental delay in small babies at term: a systematic review. Ultrasound Obstet Gynecol 2012;40:267–75. https://doi.org/10.1002/uog.11112 . - DOI - PubMed
    1. Sacchi, C, Marino, C, Nosarti, C, Vieno, A, Visentin, S, Simonelli, A. Association of intrauterine growth restriction and small for gestational age status with childhood cognitive outcomes: a systematic review and meta-analysis. JAMA Pediatr 2020;174:772–81. https://doi.org/10.1001/jamapediatrics.2020.1097 . - DOI - PubMed - PMC
    1. Murray, E, Fernandes, M, Fazel, M, Kennedy, SH, Villar, J, Stein, A. Differential effect of intrauterine growth restriction on childhood neurodevelopment: a systematic review. BJOG 2015;122:1062–72. https://doi.org/10.1111/1471-0528.13435 . - DOI - PubMed
    1. Parra-Saavedra, M, Crovetto, F, Triunfo, S, Savchev, S, Peguero, A, Nadal, A, et al.. Neurodevelopmental outcomes of near-term small-for-gestational-age infants with and without signs of placental underperfusion. Placenta 2014;35:269–74. https://doi.org/10.1016/j.placenta.2014.01.010 . - DOI - PubMed
    1. O’Keeffe, MJ, O’Callaghan, M, Williams, GM, Najman, JM, Bor, W. Learning, cognitive, and attentional problems in adolescents born small for gestational age. Pediatrics 2003;112:301–7. https://doi.org/10.1542/peds.112.2.301 . - DOI - PubMed

MeSH terms

LinkOut - more resources