Neurodevelopmental outcomes in mild and moderate isolated ventriculomegaly originating in utero .

OBJECTIVE: To determine the differences in outcomes between mild and moderate isolated ventriculomegaly (IVM).

METHODS: We conducted a prospective cohort study on 94 fetuses with IVM and evaluated the neurodevelopmental outcomes at 12 months of age using the ASQ-3 and BSID-I neurodevelopmental assessment tools. Progression of VM was defined as an increase in the width of the ventricular by at least 3 mm during sequential ultrasound monitoring. The population was divided into two groups according to ventricular width: mild (10-12 mm) and moderate (12.1-15 mm), which were further evaluated for VM progression in utero separately.

RESULTS: Neurodevelopmental assessments at 12 months were the main form of evaluations. Neurodevelopmental impairment (NDI) was defined as a mental development index (MDI) or psychomotor development index (PDI) < 85. There were no significant differences in NDI values between the mild and moderate groups ( p  = .155). Compared with the non- in utero progression group (7.6%), the rate of NDI was significantly higher ( p  = .004) in the group with progression (33.3%). Using linear regression and correlation, no negative correlation was found between the maximum value of atrial diameter (AD) in utero and the PDI ( r  = -0.021, p  = .914) or MDI ( r  = -0.073, p  = .703) score. However, the maximum change in the AD in utero was negatively correlated with both PDI ( r  = -0.460, p  = .011) and MDI ( r =-0.422, p  = .020) scores.

CONCLUSION: There were likely no differences in neurodevelopmental outcomes between mild and moderate IVM. In fetuses with mild to moderate VM, intrauterine progression may be a poor prognostic factor for neurodevelopmental outcomes.