Child neurodevelopment following a diagnosis of isolated mild ventriculomegaly: a linked population-based study

Abstract

Ventriculomegaly is a common prenatal diagnosis that has been linked with poor neurodevelopmental outcomes. Prior studies, however, have combined mild with severe cases, and included fetuses with other abnormalities. Also longer-term outcomes have been lacking. We examined if kindergarten-age child development scores following a diagnosis of isolated mild ventriculomegaly were lower than those of non-anomalous births in the general population. Singleton fetuses with an ultrasound at our tertiary center, 2004-2016, with lateral fetal ventricles diameter measuring 10.0 to 12.9 mm (unilateral or bilateral) and no other abnormal ultrasound findings were identified. Ultrasound data was linked with British Columbia (BC) population-based health data, including births in the BC Perinatal Data Registry and standardized kindergarten-age child development assessments (the Early Development Instrument [EDI]). The EDI assesses child development across five domains (emotional, social, language, communication, physical [each /10]), which sum to a Total EDI score /50. As schools only participate once per 3-year provincial testing wave, scores are available for 1/3 of births. Quantile regression was used to compare median EDI scores in children who had an antenatal diagnosis of isolated ventriculomegaly and those that did not, adjusting for sex and gestational age. We identified 65 non-anomalous pregnancies with mild ventriculomegaly, along with n= 358, 252 non-anomalous births in the BC population. EDI scores were available for approximately one-third of each group (n=23, n=124,621). Crude EDI scores were systematically lower with ventriculomegaly than the general population (e.g., Total EDI 39.3 vs 41.3, respectively; Figure 1). However, more ventriculomegaly cases were boys (67%), who also scored lower on EDI testing. After adjusting for sex, there were no differences in EDI scores (e.g., difference in Total EDI of -0.2 [95% CI: -4.2 to 3.9]; Figure 2). Isolated, mild ventriculomegaly was not associated with lower kindergarten-age child development test scores.View Large Image Figure ViewerDownload Hi-res image Download (PPT)