Date of Award
PhD (Doctor of Philosophy)
Dr. Adrienne Foran
Professor Naomi McCallion
The Children's Fund for Health, Children's University Hospital - Temple Street.
Fetal Growth Retardation, Ultrasonography, Doppler, Magnetic Resonance Imaging
Intra-uterine growth restriction (IUGR) is defined as a failure of a fetus to achieve its expected weight for a given gestational age. These infants have increased mortality and morbidity rates compared to appropriately grown infants. Deficits in cognition, language and social functions may occur. StOOPs (Short-term Outcome Of PORTO study) is a national study incorporating brain imaging to investigate differences in brain development and organisation between two groups of IUGR infants; those with normal and abnormal antenatal Doppler measurements. Antenatal Doppler examination of blood flow in the umbilical artery is used to monitor pregnancies affected with IUGR.
Singleton infants without aneuploidy or congenital anomaly and with an estimated fetal weight < 10th centile were enrolled nationally. Prospective data of delivery and infant characteristics was collected. Non-sedated 3 Tesla MRI of brain was acquired at term corrected gestation. 34 IUGR infants with abnormal umbilical arterial Doppler measurements, 29 IUGR infants with normal measurements and 11 healthy term controls were recruited. Connectivity analyses and voxel based morphometry analysis were performed. Growth and developmental assessments were performed at 1 year of age.
Resting state networks were identified. No group differences were found for the default mode network (DMN). Parts of the dorsal attention network (DAN), sensory networks and thalamic connections all showed systematic disturbance in the Abnormal Doppler group. Volumetric differences were identified between the three groups, which were correlated with one-year outcome measures. Communication scores positively correlate with volume in two cluster areas identified; a brainstem region and a region around the central gyrus. Personal & Social scores are negatively correlated with volume in a region in the right frontal lobe.
Differences between IUGR infant brains based on Doppler status are identifiable at term corrected age. These findings suggest that AbD group may benefit from early intensive interventions.
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Boyle MA. 3.0 Tesla MRI analysis of the Intra-Uterine Growth Restricted Infant Brain - Comparison of Infants with Normal and Abnormal Antenatal Doppler's [PhD Thesis]. Dublin: Royal College of Surgeons in Ireland; 2017.