Objective: To evaluate the pregnancy outcomes and neurodevelopment prognosis of subjects prenatally diagnosed with fetal ventriculomegaly (VM).
Methods: All the subjects with VM diagnosed by ultrasound and were admitted and treated at West China Second Hospital, Sichuan University between March 2011 and September 2020 were retrospectively enrolled for a chohort study, while non-VM subjects of the same period were selected with a random number table to form the control group. Pregnancy outcomes of the two groups were compared, and the fetuses of both groups were followed up after birth for further assessment and comparison of their neurodevelopmental prognosis.
Results: The live birth rate of the VM group was lower than that of the control group (77.63% [229/295] vs. 94.31% [265/281], P<0.001). Furthermore, the proportion of subjects that were transferred to NICU for monitoring and observation after birth was higher in the VM group than that of the control group (20.96% [48/229] vs. 4.53% [12/265], P<0.001). During the follow-up, it was found that the rate of neurodevelopmental abnormalities of the VM group was significantly higher than that of the control group (11.79% [27/229] vs. 1.90% [5/265], P<0.001). Moreover, neurodevelopmental abnormalities of VM fetuses were correlated to the following factors, the degree of VM ( P=0.010), intrauterine progression of VM ( P=0.024), and whether the postnatal cranial ultrasound result was suggestive of VM ( P=0.001). In addition, postnatal cranial ultrasound suggestive of VM was found to be an independent risk factor for neurodevelopmental abnormalities ( OR=9.434, 95% CI: 1.791-49.688, P=0.008).
Conclusion: VM reduces the fetal live birth rate and may increase the risks of neurodevelopmental abnormalities after birth. All VM fetuses should be closely followed up for neurodevelopment status after birth, especially those with severe VM, intrauterine progression, and postnatal cranial ultrasound indicative of VM.
目的: 评价胎儿侧脑室增宽（ventriculomegaly, VM）的妊娠结局和胎儿神经发育等预后。
方法: 采用回顾性队列研究纳入2011年3月–2020年9月四川大学华西第二医院住院收治的所有超声诊断的VM胎儿，采用随机数字表选取同时期的非VM胎儿作为对照组，比较两组间的妊娠结局及胎儿出生后的神经发育等预后情况。
结果: VM组的活产率77.63%（229/295），对照组活产率94.31%（265/281），VM组胎儿的活产率低于对照组（P<0.001），且VM组胎儿出生后转新生儿科监护观察的比例高于对照组〔 20.96%（48/229） vs. 4.53% （12/265），P<0.001〕。随访中VM组胎儿出现神经发育异常率高于对照组〔 11.79%（27/229） vs. 1.90% （5/265），P<0.001〕，且VM胎儿出生后的神经发育异常与侧脑室增宽的分度（P=0.010）、VM宫内进展（P=0.024）、出生后头颅超声是否提示VM（P=0.001）有关，且出生后头颅超声提示VM是神经发育异常的独立危险因素（OR=9.434, 95% CI： 1.791～49.688， P=0.008）。
结论: VM降低了胎儿活产率，且可能增加胎儿出生后发生神经发育异常的风险。所有VM出生后均应严密随访神经发育等情况，尤其是重度VM、出现宫内进展、出生后头颅超声结果仍提示VM者。
Keywords: Neurodevelopment; Outcome of pregnancy; Risk factor; Ventriculomegaly.
Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).