(869) The correlation of antenatal sonographic parameters and neurodevelopmental outcomes in fetal growth restriction

Objective: To determine how different antenatal sonographic parameters correlate with early childhood neurodevelopmental outcomes in fetuses categorized as fetal-growth restricted (FGR) or small-for-gestational-age (SGA).

Study Design: This was a prospective cohort of singleton FGR or SGA fetuses diagnosed after 20 weeks of gestation. FGR and SGA were defined using Delphi criteria. Using abdominal circumference (AC), umbilical vein flow (UVF) percentiles by gestational age (GA), corpus callosum length (CCL MoM), corpus vermian height (CVH MoM), transverse cerebellar diameter (TCD MoM), and the ratio of the insula circumference to head circumference (IC) from the last ultrasound before delivery, we tested for correlations to neurodevelopmental outcomes. We evaluated neurodevelopmental outcomes using the Bayley-III Scales of Infant Development (BSID). Mann-Whitney U tests compared the measurements and scales between FGR and SGA. Pearson correlation was used to compare the sonographic parameters to the BSID subscale and sum percentile scores. Using significant ultrasound parameters as predictors, a multivariate linear regression model was created for each BSID scale as a dependent variable.

Results: A total of 90 pregnancies were included in the study. BSID scores were available for 32 infants. SGA fetuses had higher UVF (p=0.001) and higher motor scores (p=0.014) compared to FGR (Table 1). EFW and AC centile correlate with motor scores, UVF correlates with language, adaptive behavior, and sum scores, and IC correlates with adaptive behavior. In the multivariate model, EFW was excluded given collinearity with AC.  In the final multivariate analyses, AC was the only significant predictor for motor, UVF was a significant predictor for language, social-emotional, and sum scores, while insula predicted adaptive behavior and sum score (Table 2).

Conclusion: AC, UVF, and IC may be useful predictors of neurodevelopmental outcomes of the growth-restricted fetus. Long-term follow-up studies with larger cohorts are needed to better evaluate the impact of antenatal sonographic parameters on later neurodevelopment.