New Ultrasound Measurements to Bridge the Gap between Prenatal and Neonatal Brain Growth Assessment

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Fig 1.
Prenatal measurement of CC and CCF lengths. 1, Corpus callosum length, outer-outer border. 2, Corpus callosum–fastigium length, from the genu of the corpus callosum to the fastigium (roof of the fourth ventricle).
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Fig 2.
Growth curves. A, Reference curves between 22 and 42 weeks of gestation for CCF (left) and CC (right) length, with the 5th, 10th, 50th, 90th, and 95th percentiles. B, Individual growth trajectories of CCF (left) and CC (right) length between 22 and 42 weeks of gestation. C, Growth trajectories for controls (black) and fetuses with FGR (striped blue) and CHD (dotted red).

Table 1:

Baseline characteristics^{^a}

Characteristics	Controls (n = 157)	FGR (n = 22)	CHD (n = 20)	Missing
Maternal
Age at enrollment (yr)	32.3 (21–44)	29.7 (21–41)	33.0 (22–48)	7
Nulliparous	69 (44)	13 (68)	11 (58)	6
Mode of conception (IVF/ICSI)	48 (31)	2 (10)	2 (11)	3
Geographic background				6
Western	126 (81)	15 (79)	18 (90)
Non-Western	29 (19)	4 (21)	2 (10)
Educational level				8
Low	20 (13)	4 (20)	0
Intermediate	56 (36)	12 (60)	7 (39)
High	79 (51)	4 (20)	11 (61)
Prepregnancy BMI (kg/m²)	22.9 (15.2–39.7)	22.9 (17.6–43.4)	23.4 (18.0–35.8)	19
Periconception folic acid initiation (yes)	149 (96)	15 (79)	18 (95)	6
Periconception smoking (yes)	25 (16)	3 (16)	3 (16)	8
Periconception alcohol consumption (yes)	44 (29)	4 (21)	10 (53)	9
Neonatal
Birth weight (g)	3345 (2035–4380)	1400 (400–2900)	3420 (1650–4140)	2
Gestational age at birth (wk)	39⁺¹ (37⁺⁰–41⁺⁵)	34⁺² (26⁺³–39⁺³)	38⁺⁶ (28⁺⁴–41⁺⁵)	2
Males	82 (52)	11 (50)	13 (65)	0

Note:—BMI indicates body mass index; IVF/ICSI, in vitro fertilization with or without intracytoplasmic sperm injection; ICSI, intracytoplasmic sperm injection.
↵a Data are presented as median and range or number and percentage. Missing data were due to incomplete questionnaires.

Table 2:

Success rates and means of corpus callosum and corpus callosum–fastigium length per gestational age^{^a}

Length (mm)/GA (wk)	US Scans (No.)	Measurements (No.)	Success Rate (%)	Mean (SD) (mm)
CC
22	166	124	75	26.35 (1.22)
26	188	138	73	34.33 (1.86)
32	188	115	61	41.56 (2.19)
42	143	138	97	48.09 (3.15)
CCF
22	124	89	72	33.09 (1.61)
26	138	82	59	39.39 (1.92)
32	115	81	70	45.86 (2.07)
42	143	138	97	52.26 (3.12)

↵a Presented are the success rates, means, and corresponding SD values of the CC and CCF measurements per full week of gestation. The success rates for CC length and postnatal CCF length were calculated by the number of successful measurements divided by the total number of US images. Success rates of prenatal CCF measurements were calculated by dividing the number of successful CCF measurements by the number of midsagittal images eligible for CC length.

Table 3:

Intraobserver and interobserver reliability for prenatal measurements of corpus callosum and corpus callosum–fastigium length^{^a}

Note:—ICC indicates intraclass correlation coefficient.
↵a Intra- and interobserver reliability analyses for prenatal CC and CCF measurements in a random selection of 30 ultrasound scans.

Table 4:

Linear mixed models—growth trajectories of CC and CCF influenced by the presence of fetal growth restriction and congenital heart defects^{^a}

↵a Data are presented in β values with corresponding 95% CI and P values, compared with controls. Model 1 represents the crude model with GA and its polynomials as predictor and type of case as covariate of interest. Model 2 is the fully adjusted model for the covariates in model 1 and for serial measurements of fetal weight and sex.
↵b Significant.