Impact of Intrauterine Growth Restriction on Neonatal Frontal Lobe Dimensions (Transcranial Sonographic Measurments)
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- Category: Vol. 79, September 2011
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Impact of Intrauterine Growth Restriction on Neonatal Frontal Lobe Dimensions (Transcranial Sonographic Measurments),EMAN A. AHMED and NAFISA H.R. ABD EL-AZIZ
Abstract
Assessing the impact of restricted intrauterine growth on neonatal frontal lobe (FL) dimensions is important. Children with intrauterine growth restriction were found to have lower intelligence quotient, more frequent neuropsycho logical difficulties, difficulties in executive functioning, inflexible creativity, and language, indicative of frontal lobe dysfunction. This study aims to evaluate the impact of intrauterine growth restriction and small head circumference (HC) on neonatal frontal lobe dimensions. We measured frontal lobe dimensions at birth by using a recently published ultrasonic technique. We included 92 newborn infants born at GA of 37-41 WKS: (42) appropriate for GA and normal HC, and [50] small for GA and small HC. Infants with a 5-min Apgar score <7, severe congenital malformations, or chromosomal abnormalities were excluded. Through a coronal ultrasound scan via the anterior fontanel at the level where the most lateral point of the Sylvian fissure was best demonstrated, we drew a triangle connecting the most lateral point of the Sylvian fissure, the corpus callosum, and the subcalvarian point of the interhemi-spheric fissure. We measured the three sides of the triangle, Sylvian-fontanellar distance (SFD), Sylvian-callosal distance (SCD), and fontanellar-callosal distance (FCD), and calculated the frontal triangular area (FTA). The SGA neonates in our study had significantly smaller FL dimensions (SFD, SCD, FCD, and FTA) than their AGA mates. All four FL dimensions were strongly correlated with HC and birth weight in both AGA and SGA groups. It is concluded that IUGR has a great impact on FL dimensions which could have a considerable
Abbreviations:
AGA: Appropriate for gestational age. SGA : Small for gestational age.
BW : Birth weight.
FCD : Fontanellar-callosal distance. FL : Frontal lobe.
FTA : Frontal triangular area.
GA : Gestational age.
HC : Head circumference.
IUGR: Intrauterine growth restriction. MRI : Magnetic resonance imaging. SCD : Sylvian-callosal distance.
SFD : Sylvian-fontaneller distance. US : Ultrasonography.
effect on neurodevelopment of those neonates. US assessment proved to be simple, fast and reproducible in this situation.