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Neurodevelopmental outcome at 2 years of corrected age in fetuses with increased nuchal translucency thickness and normal karyotype compared with matched controls.

Authors
  • Buffin, R1, 2
  • Fichez, A2
  • Decullier, E3
  • Roux, A3
  • Bin, S3
  • Combourieu, D4
  • Pastor-Diez, B1
  • Huissoud, C2
  • Picaud, J-C1, 2, 5
  • 1 Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service de Néonatologie, Lyon, France. , (France)
  • 2 Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Centre Pluridisciplinaire de Diagnostic Prénatal, Lyon, France. , (France)
  • 3 Hospices Civils de Lyon, Pole IMER, Unité de Recherche Clinique, Lyon, France. , (France)
  • 4 Hospices Civils de Lyon, Hôpital Mère Enfant, Centre Pluridisciplinaire de Diagnostic Prénatal, Bron, France. , (France)
  • 5 Université Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux, Pierre Bénite, Lyon, France. , (France)
Type
Published Article
Journal
Ultrasound in Obstetrics and Gynecology
Publisher
Wiley (John Wiley & Sons)
Publication Date
May 01, 2021
Volume
57
Issue
5
Pages
790–797
Identifiers
DOI: 10.1002/uog.22009
PMID: 32149439
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Increased nuchal translucency (NT) thickness is an antenatal marker of aneuploidy or malformation that can lead to termination of pregnancy. This study assessed the long-term neurodevelopmental prognosis of infants who had isolated increased NT in utero. This was a prospective cohort study of infants with a NT thickness > 95th percentile in the first trimester, but with a normal karyotype and no major anomalies, and controls with normal NT matched for birth weight, Apgar score, place of birth, parity and gestational age at birth. At 2 years of corrected age, all infants underwent the psychometric Brunet-Lézine test to evaluate their developmental quotient (DQ), overall (global) and specifically for the areas of posture, language, coordination and sociability. A total of 203 chromosomally normal infants were included in the increased-NT group and 208 in the control group. The mean global DQ was significantly lower in the increased-NT group than in the control group (108.6 ± 9.7 vs 112.8 ± 8.3; P < 0.0001), but it was within the normal range expected for that age in both groups. Similarly, the mean DQs for coordination, sociability and language, but not for posture, were significantly lower in infants with increased NT than in controls. Only one case with increased NT had a DQ < 70 (defined as severe neurodevelopmental impairment), compared with none in the control group. The difference between the two groups remained significant for a NT threshold ≥ 99th percentile and when the data were adjusted for NT thickness, the infant's sex and the mother's educational level. In the increased-NT group, NT thickness was < 3.5 mm in over half (56%) of the infants, between 3.5 mm and 5 mm in 33% and > 5 mm in 11%, with a mean global DQ of 108.4, 110.1 and 109.7, respectively. Infants who had isolated increased fetal NT in the first trimester had a significantly lower, but normal, DQ at a corrected age of 2 years, when compared with controls. The findings were independent of the infant's sex, fetal NT thickness and the mother's educational level. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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