Fetal neurosonographic assessment of cortical development in late-onset Fetal growth restriction and small for gestational age fetuses.

OBJECTIVE

To evaluate whether late-onset fetal growth restriction (LO-FGR) is associated with distinct alterations in cortical sulcation and midline brain structures compared with small-for-gestational-age (SGA) and appropriately grown (AGA) fetuses, and to examine how these changes relate to cerebroplacental redistribution.

STUDY

DESIGN

This prospective cross-sectional study included 84 LO-FGR, 64 SGA, and 120 AGA fetuses examined between 32 and 36 weeks' gestation. Targeted neurosonography assessed cortical sulcation, corpus callosum length, and cranio-cortical width, together with Doppler evaluation of the cerebroplacental ratio (CPR).

RESULTS

LO-FGR fetuses demonstrated shallower Sylvian fissures, shorter corpus callosum length, increased insular depth, and wider lateral cranio-cortical width compared with both SGA and AGA fetuses (all p < 0.001). These neurosonographic differences were more pronounced in the presence of abnormal CPR.

CONCLUSION

LO-FGR is associated with specific cortical and midline brain alterations distinct from both SGA and AGA, with the severity of these changes modulated by cerebroplacental redistribution.