Neurodevelopmental Outcomes of Prenatally Diagnosed Central Nervous System Abnormalities

Objectives: To evaluate postnatal neurodevelopmental outcomes of central nervous system (CNS) abnormalities diagnosed by prenatal ultrasonography and/or magnetic resonance imaging. Methods: This study was conducted on 414 pregnancies with fetuses having various CNS abnormalities that were evaluated in the perinatology council from January 2019 to December 2021. The collected data includes pregnancy outcomes, prenatal and postnatal neuroimaging findings, laboratory results for congenital infections and genetic analysis. The assessment of neurodevelopmental outcome of the infants alive was carried out prospectively using the Denver Developmental Screening Test-II.

Results: A total of 37.9% pregnancies (157/414) were terminated and 3.4% (14/414) were resulted in stillbirth, abortion or spontaneous intrauterine death. A total of 36% pregnancies (149/414) resulted in live birth and 29.2% (121/414) of the infants were still alive. A total of 50% infants alive (56/112) were evaluated with DDST-II. While normal neurodevelopmental outcomes were detected in 60.7% of the infants (n=34); abnormal neurodevelopmental outcomes were found in 39.3% of the infants (n=22). We reported severe, moderate, and mild neurodevelopmental delay in eleven, six and five infants, respectively. Neural tube defect anomaly was detected in 55% of the patients with severe neurodevelopmental outcome.

Conclusions: The outcomes and prognosis of CNS abnormalities diagnosed in the perinatal period vary according to the severity and properties of the abnormality detected. Prenatal and postnatal follow-up, counseling and appropriate postnatal treatment are the key factors in the management of prenatally diagnosed CNS abnormalities.