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Cerebral Maturation in IUGR and Appropriate for Gestational Age Preterm Babies

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Abstract

Intrauterine growth restriction (IUGR) is associated with increased risk of perinatal morbidity and mortality, as well as long-term neurological deficits. However, neurostructural correlations with observed developmental disabilities have not yet been established. Magnetic resonance imaging (MRI) could prove useful for assessing brain development in the early neonatal period. We evaluated cerebral lesions and morphological maturation by MRIs in 59 preterm neonates, in order to verify the hypothesis that IUGR interferes on human brain development. A total of 26 pregnancies were complicated by IUGR and 33 pregnancies delivered preterm at a comparable gestational age with appropriate for gestational age (AGA). Magnetic resonance examination was performed at the completion of 41 weeks’ gestation. White matter disease studied with MR included periventricular cavitations and punctuate lesions characterized by increased signal on T1-weighted and decreased signal on T2-weighted images. Cerebral maturation was defined by the total maturation score, on the basis of 4 morphological parameters of cerebral maturation: myelination (M), cortical infolding (C), germinal matrix distribution (GM), and glial cell migration pattern (G). No difference in brain lesions and in the level of cerebral maturation was found between preterm AGA and IUGR neonates. However, myelination was significantly reduced in IUGR neonates with brain sparing compared to IUGR neonates with normal Doppler of middle cerebral artery. Our study could not demonstrate any major significant difference between preterm AGA and IUGR neonates in terms of lesion occurrence and cerebral maturation. We observed, however, a mild delay in myelination in IUGR with brain sparing in utero. The relevance of this finding needs to be investigated with long-term follow-up.

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Authors and Affiliations

  1. NICU, “Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico,” University Department of Mother and Infant Sciences, Università degli Studi di Milano, Milan, Italy

    Luca A. Ramenghi MD, PhD, Agnese De Carli MD, Monica Fumagalli MD & Fabio Mosca MD

  2. Unit of Obstetrics and Gynecology, Department of Clinical Sciences, Ospedale Luigi Sacco, University of Milan, via GB Grassi 74, 20157, Milan, Italy

    Anna Martinelli MD, Luca Mandia MD & Irene Cetin MD

  3. Center for Fetal Research Giorgio Pardi, University of Milan, Milan, Italy

    Anna Martinelli MD, Valentina Brusati MD, PhD, Luca Mandia MD, Fabio Mosca MD & Irene Cetin MD

  4. Department-Ospedale dei Bambini Vittore Buzzi ICP, Paediatric Radiology, Milan, Italy

    Fabio Triulzi MD

Authors
  1. Luca A. Ramenghi MD, PhD
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  2. Anna Martinelli MD
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  3. Agnese De Carli MD
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  4. Valentina Brusati MD, PhD
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  5. Luca Mandia MD
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  6. Monica Fumagalli MD
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  7. Fabio Triulzi MD
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  8. Fabio Mosca MD
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  9. Irene Cetin MD
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Correspondence to Irene Cetin MD.

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Ramenghi, L.A., Martinelli, A., De Carli, A. et al. Cerebral Maturation in IUGR and Appropriate for Gestational Age Preterm Babies. Reprod. Sci. 18, 469–475 (2011). https://doi.org/10.1177/1933719110388847

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  • DOI: https://doi.org/10.1177/1933719110388847

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