Prenatal and postnatal outcomes in fetuses with ventriculomegaly: Prognostic factors insights from a single-center study

IF 2.1 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development Pub Date : 2025-10-01 Epub Date: 2025-08-01 DOI:10.1016/j.earlhumdev.2025.106355

Murad Gezer , Abdullah Tabakçı , Ümit Taşdemir , Mucize Eriç Özdemir , Zeycan Aytaş , Oya Demirci

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引用次数: 0

Abstract

Objective

Fetal ventriculomegaly (VM) is a common prenatal ultrasound finding with a wide range of etiologies and variable prognostic outcomes. This study aimed to evaluate the prenatal characteristics, genetic findings, and postnatal neurodevelopmental outcomes of fetuses diagnosed with VM, according to the severity of VM and associated abnormalities.

Methods

This retrospective single-center study includes 357 fetuses diagnosed with VM between 2020 and 2024. Cases were classified according to VM severity, laterality, and the presence of associated anomalies. Prenatal genetic tests, neurosonography, and prenatal and postnatal MRI findings were analyzed. Outcomes included the termination of pregnancy, intrauterine and postnatal death, and long-term neurodevelopmental status.

Results

Among 357 fetuses, 193 (54.1 %) had mild VM, 85 (23.8 %) had moderate VM, and 79 (22.1 %) had severe VM. 25.2 % of the cases were isolated. Additional CNS abnormalities were present in 43.1 % of the fetuses. Genetic or chromosomal abnormalities were detected in 35.7 % of the fetuses who underwent genetic testing (55 out of 154 cases). The survival rate was highest in mild (75.6 %) and isolated VM (95.6 %). A higher gestational age at diagnosis, smaller ventricular diameter, and the absence of CNS/extracranial CNS abnormalities were associated with normal neurodevelopmental outcomes. In the logistic regression analysis, the presence of CNS abnormalities, ventricular width, and gestational age at diagnosis were found to be independent predictors of neurodevelopmental status. ROC analysis in our study showed that the cut-off value of 13 mm had good discrimination to predict normal neurodevelopmental status in all cases but limited accuracy in isolated cases of VM.

Conclusion

The severity and etiology of fetal VM significantly affect both survival and neurodevelopmental outcomes. Isolated mild VM correlated with positive outcomes, but moderate-to-severe VM and non-isolated cases had markedly poor survival rates and neurodevelopmental status. Key prognostic factors for normal neurodevelopmental status included higher gestational age at diagnosis, smaller ventricular diameters <13 mm, and the absence of CNS and non-CNS anomalies.

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脑室肥大胎儿的产前和产后结局：来自单中心研究的预后因素见解

目的胎儿心室肿大（VM）是一种常见的产前超声发现，病因广泛，预后不一。本研究旨在根据VM的严重程度和相关异常，评估诊断为VM的胎儿的产前特征、遗传发现和出生后神经发育结局。方法回顾性单中心研究纳入357例诊断为VM的胎儿，时间为2020年至2024年。病例根据VM的严重程度，侧边性和相关异常的存在进行分类。分析了产前基因检测、神经超声检查以及产前和产后MRI检查结果。结果包括终止妊娠、宫内和产后死亡以及长期神经发育状况。结果357例胎儿中，轻度VM 193例（54.1%），中度VM 85例（23.8%），重度VM 79例（22.1%）。25.2%的病例被隔离。43.1%的胎儿存在额外的中枢神经系统异常。遗传或染色体异常在接受基因检测的胎儿中占35.7%（154例中有55例）。轻度和分离VM的存活率最高，分别为75.6%和95.6%。诊断时胎龄较高，心室直径较小，无中枢神经系统/颅外中枢神经系统异常与正常的神经发育结果相关。在logistic回归分析中，发现中枢神经系统异常、心室宽度和诊断时的胎龄是神经发育状态的独立预测因子。本研究的ROC分析显示，截断值13 mm对所有病例的正常神经发育状态都有很好的判别性，但在孤立的VM病例中准确性有限。结论胎儿VM的严重程度和病因对胎儿的生存和神经发育结局均有显著影响。孤立的轻度VM与阳性结果相关，但中度至重度VM和非孤立病例的存活率和神经发育状态明显较差。正常神经发育状态的关键预后因素包括诊断时胎龄较大，心室直径较小（约13 mm），无中枢神经系统和非中枢神经系统异常。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Early human development 医学-妇产科学

CiteScore

4.40

自引率

4.00%

发文量

100

审稿时长

46 days

期刊介绍： Established as an authoritative, highly cited voice on early human development, Early Human Development provides a unique opportunity for researchers and clinicians to bridge the communication gap between disciplines. Creating a forum for the productive exchange of ideas concerning early human growth and development, the journal publishes original research and clinical papers with particular emphasis on the continuum between fetal life and the perinatal period; aspects of postnatal growth influenced by early events; and the safeguarding of the quality of human survival. The first comprehensive and interdisciplinary journal in this area of growing importance, Early Human Development offers pertinent contributions to the following subject areas: Fetology; perinatology; pediatrics; growth and development; obstetrics; reproduction and fertility; epidemiology; behavioural sciences; nutrition and metabolism; teratology; neurology; brain biology; developmental psychology and screening.