[Clinical analysis of pregnancy outcomes and prognosis for fetal ventriculomegaly].

Objective

To investigate the factors affecting the clinical outcomes of fetuses with ventriculomegaly (VM), and to provide help for the clinical management of fetuses with VM.

Methods

This was a retrospective study. A total of 208 singleton pregnant women diagnosed with fetal VM in Xuzhou Central Hospital from January 2017 to June 2025 were enrolled. According to the pregnancy outcome, the subjects were divided into induction group (63 cases) and live birth group (145 cases). The two groups were compared in terms of gravidity and parity, mode of conception, parental age at delivery, maternal body mass index (BMI) in early pregnancy, maternal education background, pregnancy complications, adverse pregnancy history, family expectations for the fetus, fetal VM combined intracranial and extracranial abnormalities, and prenatal diagnosis genetic abnormalities. Logistic regression was used to analyze the influencing factors of fetal VM pregnancy outcomes. The clinical outcomes and postnatal development of newborns were followed up.

Results

(1) There were no significant differences between induction group and live birth group in terms of gravidity, mode of conception, parental age at delivery, maternal BMI in early pregnancy, adverse pregnancy history, extracranial abnormalities, and high family expectations (all P>0.05). (2) The proportions of moderate VM, severe VM, bilateral VM, asymmetric VM, intrauterine progressive VM, VM combined with intracranical abnormalities, fetal genetic abnormalities, pregnancy complications in the induction group were significantly higher than those in the live birth group, while the proportion of high maternal education level was lower than that in the live birth group (all P<0.05). (3) Univariate logistic regression analysis showed that moderate to severe VM, bilateral VM, asymmetric VM, intrauterine progressive VM, VM combined with intracranial abnormalities and genetic abnormalities were risk factors for induction of labor in VM fetuses, while high maternal education level was a protective factor for live birth in VM fetuses (all P<0.05). Multivariate logistic regression analysis showed that moderate to severe VM, bilateral VM, intrauterine progressive VM, and prenatal genetic abnormalities were independent risk factors for abortion of VM fetuses, and high maternal education level was an independent protective factor for live birth of VM fetuses (all P<0.05). (4) Among the 145 live births, 5 were preterm births and 140 were term births. During the follow-up period (6 months to 7 years after birth), 139 cases were normal, 1 case died at 6 months after birth, 1 case had Crouzon syndrome, and 4 cases had motor and/or language development disorders.

Conclusions

Moderate to severe VM, bilateral VM, intrauterine progressive VM, genetic abnormalities, and high maternal education level are independent risk factors for fetal VM. Multidisciplinary team cooperation, combined with dynamic long-term follow-up mode, could provide help for the clinical management of fetal VM.