Effect of fetal growth restriction on the development of regional brain volume and neurodevelopmental outcomes: Evidence from magnetic resonance imaging based on a fully automated segmentation method.

PURPOSE: To investigate the impact of fetal growth restriction (FGR) on brain volume development and to identify imaging indicators predictive of poor neurodevelopmental outcomes.

METHODS

The MRI images of fetuses with FGR diagnosed by ultrasound at 27-38 weeks and matched normal fetuses were collected. The isotropic high-resolution images were reconstructed and processed to extract 17 brain regions. Subsequently, volume and the ratio to total brain volume of each brain region was calculated. Using logistic regression analysis to identify the independent risk factors of the neurodevelopmental outcomes.

RESULTS

The study included 51 FGR fetuses and 78 healthy controls (HCs). Significant differences were discovered in the cingulate gyrus, brainstem, corpus callosum, basal ganglia, insula, frontal lobe, temporal lobe, parietal lobe and cerebrospinal fluid of their ratio to the total brain volume between the two groups (P<0.05). The prognostic group consisted of 28 fetuses with good fetal neurodevelopment and 15 fetuses with poor neurodevelopment. The ratio of brainstem was identified as independent predictors for poor neurodevelopmental outcome (OR: 2.069; 95 % CI: 1.061 to 4.035).

CONCLUSION

Brain development was not uniformly restricted in FGR fetuses. Additionally, the ratio of brainstem to total brain volume may be associated with poor neurodevelopment.