Fetal neurosonography at 31–35 weeks reveals altered cortical development in pre‐eclampsia with and without small‐for‐gestational‐age fetus

作者：A. Basso, L. Youssef, A. Nakaki, Cristina Paulés, Jezid Miranda, Giulia Casu, Laura Salazar, E. Gratacós, E. Eixarch, F. Crispi, F. Crovetto · 发表于：Ultrasound in Obstetrics and Gynecology · 年份：2022 · DOI：10.1002/uog.24853 · 被引用次数：29 · 研究领域：Fetal and Pediatric Neurological Disorders、Pregnancy and preeclampsia studies、Neonatal and fetal brain pathology

OBJECTIVE: To explore the pattern of fetal cortical development in pregnancies complicated by pre-eclampsia (PE), with and without a small-for-gestational-age (SGA) fetus, compared to uncomplicated pregnancies. METHODS: centile) (n = 77), PE with an appropriate-for-gestational-age (AGA) fetus (n = 76) or PE with a SGA fetus (n = 67), and 128 uncomplicated pregnancies (normotensive AGA) matched by gestational age at ultrasound. All pregnancies underwent detailed neurosonography, using a transabdominal and transvaginal approach, at 31-35 weeks' gestation to assess the depth of the insula, Sylvian fissure, parieto-occipital sulcus, cingulate sulcus and calcarine sulcus. All measurements were adjusted for biparietal diameter (BPD). In addition, a grading score of cortical development was assigned to each brain structure, ranging from Grade 0 (no development) to Grade 5 (maximum development). Univariate and multiple regression analyses were conducted. RESULTS: Similar to findings in previous studies, normotensive pregnancies with a SGA fetus showed significant differences in cortical development compared with controls, with reduced Sylvian fissure depth adjusted for BPD (14.5 ± 2.4 vs 16.6 ± 2.3; P < 0.001) and increased insula depth adjusted for BPD (33.2 ± 2.0 vs 31.8 ± 2.0; P < 0.001). Interestingly, a similar cortical development pattern was observed in PE pregnancies with a SGA fetus and in PE pregnancies with an AGA fetus, manifested by reduced Sylvian fissure depth adjusted...