Neurodevelopmental outcomes in mild and moderate isolated ventriculomegaly originating in utero

Abstract

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.