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Cross-sectional reference values of cerebral ventricle for Chinese neonates born at 25–41 weeks of gestation

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Abstract

To establish the cross-sectional reference values of cerebral ventricular size for the Chinese newborns by the most correlated explanatory variables. The anterior horn width (AHW), thalamo-occipital distance (TOD), and ventricular index (VI) were collected prospectively from 1- to 7-day neonates without potential neurological problems. All neonates were delivered or treated at the Hunan Provincial Maternal and Child Health Care Hospital or Second Xiangya Hospital of Central South University between February and August 2021. The most correlated explanatory variables were identified with the max–min normalization and multiple regression. The reference values were then established based on the above variables. Additionally, intraclass correlation coefficients (ICC) were applied to evaluate the reliability of the overall data collection process. This prospective study consisted of 1848 neonates. The AHW was most highly correlated with GA; the TOD and VI were most strongly correlated with birth weight. All the foregoing correlations were positive ones. Heteroscedasticity and influential points existed in both TOD and VI. The ICCAHW was the largest to a specific rater or between raters, the ICCTOD the second largest, and the ICCVI the smallest.

Conclusions: We recommend using the GA-based AHW reference values and birth weight-based TOD and VI ones. We also present a comparison of GA-based upper limits from all available reference intervals. Moreover, we determine that measurement errors are the primary cause of influential points and heteroscedasticity in TOD and VI studies and infer that the studies of TOD and VI are vulnerable to them.

What is Known:

• Reference values of infantile cerebral ventricles are vital in diagnosing and treating cerebral ventricular dilatation.

• Precursors established gestational age-based reference values subjectively.

What is New:

• We set cross-sectional reference values based on the most correlated variables for Chinese neonates and compared all available gestational age-based upper limits.

• Influential points and heteroscedasticity mainly caused by measurement errors are common in TOD and VI studies.

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Data availability

Not applicable because a further radiomics study will be conducted based on these data.

Code availability

The statistical analyses and graphs were made via Stata15.1 (StataCorp, Texas, USA), JMP Pro 16 (SAS, North Carolina, USA), GraphPad Prism 8.2.1 (GraphPad, California, USA), and BioRender (BioRender.com).

Abbreviations

AHW:

Anterior horn width

cPVL:

Cystic periventricular leukomalacia

GA:

Gestational age

HCSEE:

Heteroskedasticity-consistent standard error estimator

HPMCHCH:

The Hunan Provincial Maternal and Child Health Care Hospital

ICC:

Intraclass correlation coefficient

NQCG:

Non-quality control group

OLS:

Ordinary least squares

PHHP:

Posthemorrhagic hydrocephalus of prematurity

PHVD:

Posthemorrhagic ventricular dilation

PIVH:

Periventricular-intraventricular hemorrhage

QCG:

Quality control group

SXHCSU:

The Second Xiangya Hospital of Central South University

TOD:

Thalamo-occipital distance

VI:

Ventricular index

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Acknowledgements

We appreciate the staff members of the multidisciplinary teams who devote themselves to the health of high-risk newborns and thank all the subjects’ parents for their kindness and willingness to help future patients. Additionally, we are grateful to Ms. Guangmin Dai for her contribution to data input.

Funding

All phases of this study were supported by the Major Scientific and Technological Projects for collaborative prevention and control of birth defects in Hunan Province, China (Grant No. 2019SK1010), Natural Science Foundation of Hunan Province, China (Grant No. 2021JJ70008), Science and Technology Innovation Projects of Hunan Province, China (Grant No. 2018SK50504), and Scientific Research Project of Hunan Provincial Commission, China (Grant No. 20200951, B2019030, and 202209023037.00).

Author information

Authors and Affiliations

  1. Department of Ultrasonography, the Second Xiangya Hospital of Central South University, No. 139 Renmin Middle Road, Hunan, 410028, Changsha, China

    Yulin Peng, Longmei Yao & Shi Zeng

  2. Department of Ultrasonography, the Hunan Provincial Maternal and Child Health Care Hospital, No. 53 Xiangchun Road, Hunan, 410008, Changsha, China

    Yulin Peng, Beilei Huang, Yingchun Luo & Xiaoliang Huang

Authors
  1. Yulin Peng
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  2. Beilei Huang
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  4. Xiaoliang Huang
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  5. Longmei Yao
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  6. Shi Zeng
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Contributions

Conceptualization: Yulin Peng and Shi Zeng. Methodology: Yulin Peng and Beilei Huang. Formal analyses and investigation: Yulin Peng, Beilei Huang, and Longmei Yao. Writing–original draft preparation: Yulin Peng. Writing–review and editing: Yulin Peng, Beilei Huang, Xiaoliang Huang, Longmei Yao, Yingchun Luo, and Shi Zeng. Funding acquisition: Yingchun Luo. Resources: Yulin Peng, Beilei Huang, Yingchun Luo, Xiaoliang Huang, Longmei Yao, and Shi Zeng. Supervision: Shi Zeng, Xiaoliang Huang, and Yingchun Luo.

All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Shi Zeng.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committees of the Hunan Provincial Maternal and Child Health Care Hospital and Second Xiangya Hospital of Central South University.

Consent to participate

Written informed consent was obtained from all patients’ parents individually in this study.

Consent for publication

The authors affirm that the human research participant’s parents provided informed consent for the publication of the images in Fig. 2a, b.

Conflict of interest

The authors declare no competing interests.

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Communicated by Daniele De Luca

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Peng, Y., Huang, B., Luo, Y. et al. Cross-sectional reference values of cerebral ventricle for Chinese neonates born at 25–41 weeks of gestation. Eur J Pediatr 181, 3645–3654 (2022). https://doi.org/10.1007/s00431-022-04547-z

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