Clinical characteristics and prediction of neurodevelopmental outcomes of infants with ventriculomegaly in utero: A prospective observational study

Abstract

Background: To evaluate the clinical features and neurodevelopmental outcomes of infants with fetal ventriculomegaly (VM) and determine prognostic factors. Methods: We studied 167 VM fetuses, assessed the perinatal outcome and the neurodevelopmental outcome at age of 18 months by Bayley Scales of Infant Development. We assessed the association of clinical features and characteristics of VM with Mental Development Index (MDI) and Psychomotor Development Index (PDI). Results: Among the 167 VM fetuses, 23 underwent induced abortion or were stillborn, and 130 completed a thorough VM evaluation and postnatal follow-up. Of 130 cases, 47% (61/130) showed isolated VM and 53% (69/130) non-isolated VM. Non-isolated VM cases had a higher rate of bilateral (52% vs.25%), severe (12% vs.2%), and progressive (16% vs.10%) VM compared with isolated VM. Neurodevelopmental outcome differed between the isolated and non-isolated VM groups, and the mild and severe VM groups. Progressive VM cases had lower PDI (p=0.006). Anomalies in the CNS, urogenital system, and gastrointestinal tract were associated with lower MDI (ORCNS 4.19,95%CI 1.56-11.28;ORUrogenity 7.00,95%CI 1.81-27.07) or PDI (ORCNS 4.61,95%CI 1.79-11.85;ORGastrointestine 7.88,95%CI 1.24-50.18). Cases with lower MDI or PDI were more likely to have multiple anomalies (both CNS and non-CNS anomalies) (MDI: OR 5.78,95%CI 1.57-21.30,p=0.004, PDI: OR 7.20,95%CI 1.98-26.24,p=0.001). Conclusions: The neurodevelopmental outcomes in a fetus with VM were poor when VM was severe or progressive VM, or accompanied by structural anomalies. Cerebral, urogenital, and gastrointestinal structural anomalies contribute to poor neurodevelopmental outcomes.