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Brain Sparing Effect on Neurodevelopment in Children with Intrauterine Growth Restriction: A Systematic Review. | LitMetric

Brain Sparing Effect on Neurodevelopment in Children with Intrauterine Growth Restriction: A Systematic Review.

Children (Basel)

Obstetrics and Gynecology Section at Surgical Specialties, Biochemistry and Immunology Department, Medicine School, Málaga University, 29071 Málaga, Spain.

Published: August 2021

AI Article Synopsis

  • Fetal growth restriction (FGR) is linked to adverse cognitive, behavioral, and academic outcomes in childhood, and while "brain sparing" typically helps protect brain blood flow, it may not fully prevent developmental issues.
  • A systematic review revealed that out of 526 studies reviewed, only 12 qualified, showing that brain sparing correlated with lower cognitive abilities and IQ scores, while cerebral redistribution indicated improved executive function and behavior at age 4, but not at age 12.
  • The findings suggest that brain sparing isn't a complete safeguard against cognitive and behavioral deficits in children with FGR, with considerable variation in results across studies.

Article Abstract

Background: Fetal growth restriction (FGR) is a pregnancy complication. Multiple studies have connected FGR to poor cognitive development, behavior disorders, and academic difficulties during childhood. Brain sparing has traditionally been defined as an adaptive phenomenon in which the brain obtains the blood flow that it needs. However, this adaptive phenomenon might not have a complete protective effect. This publication aims to systematically review the consequences of brain redistribution on neurodevelopment in children who presented with placental intrauterine growth restriction.

Methods: We performed a systematic review according to PRISMA guidelines. It included studies on intrauterine growth restriction or small-for-gestational-age (SGA) fetuses, which middle cerebral artery was measured, and neurodevelopment assessed during childhood. PUBMED and EMBASE databases were searched for relevant published studies.

Results: Of the 526 studies reviewed, only 12 were included. Brain sparing was associated with poor cognitive function and lower scores in IQ. Cerebral redistribution was related to better executive function and better behavior at 4 years old but not at 12 years old.

Conclusions: We can assume that fetal brain sparing could not be a fully protective phenomenon. We could not find clinical differences in behavioral and executive functions because the results were heterogeneous. Some cognitive abilities could be affected in FGR brain sparing fetuses.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471063PMC
http://dx.doi.org/10.3390/children8090745DOI Listing

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