Fetal brain growth and development

Abstract

The main aim of this project was to create international standards for fetal brain structures size using ultrasound measurements. Fetal brain growth and development is routinely studied using prenatal ultrasound. Ultrasound is used mainly in antenatal care to diagnose fetal abnormalities but it is also essential in evaluating fetal growth and central nervous system development. Fetal growth restriction can affect neurodevelopment and therefore a population at low risk of growth problems should be selected to create such standards. Women recruited in the fetal study of the INTERGROWTH-21st Project represent the ideal candidate. This study uses a ‘prescriptive’ other than a ‘descriptive’ design to study the fetal growth, i.e. only children from populations with minimal environmental constraints on growth were included. Previous studies on fetal growth are associated with high risk of bias when a descriptive approach was used. A systematic review of the literature has been performed to identify all the studies aimed to create brain structures charts. There is substantial heterogeneity in the methodology used in previous studies aimed to create brain structures charts. As a conclusion international standards are required. International standards for six fetal brain structures size measured by antenatal ultrasound have been created with the highest quality methodology and good results of the model fitted. Those standards provide guidelines for ultrasound evaluation of the fetal brain and further understanding into the fetal brain development process in babies at low risk of abnormal neurological outcome.