1
|
Laptook AR, Chalak L, Pappas A, Davis A, Sanchez PJ, Van Meurs KP, Oh W, Sommers R, Shankaran S, Hensman AM, Rouse DJ, McDonald S, Das A, Goldberg RN, Ambalavanan N, Gyamfi-Bannerman C, Thom EA, Higgins RD. The effects of betamethasone on the amplitude integrated EEG of infants born at 34- or 35-weeks gestation. J Perinatol 2022; 42:1615-1621. [PMID: 35618748 PMCID: PMC9699898 DOI: 10.1038/s41372-022-01415-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/21/2022] [Accepted: 05/13/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Assess if maternal betamethasone administration at 34-35 weeks accelerated neonatal amplitude integrated EEG (aEEG) maturation. STUDY DESIGN Nested, observational cohort in 7 centers participating in the Antenatal Late Preterm Steroid randomized trial. Up to 2 aEEGs were obtained in neonates born from 340-356 weeks gestation before 72 h (aEEG 1) and at 5-7 days (aEEG 2) if hospitalized. Personnel and aEEG central readers were masked to the intervention. The primary outcome was maturation reflected by cycle frequency; secondary outcomes were border voltage, span, and discontinuity. RESULTS 58 neonates were enrolled (betamethasone, 28, placebo, 30). On aEEG 1, cycle frequency did not differ, but betamethasone exposed infants had a greater lower border voltage and a broader span. On aEEG 2, both groups displayed increases in lower border voltage. CONCLUSIONS Betamethasone associated changes in lower border voltage support accelerated electrical activity. Further investigation is needed to understand the broader span.
Collapse
Affiliation(s)
- Abbot R. Laptook
- Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI, USA
| | - Lina Chalak
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Athina Pappas
- Department of Pediatrics, Wayne State University, Detroit, MI, USA
| | - Alexis Davis
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA, USA
| | - Pablo J. Sanchez
- Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State College of Medicine, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - Krisa P. Van Meurs
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital, Palo Alto, CA, USA
| | - William Oh
- Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI, USA
| | - Ross Sommers
- Neonatology, Wellington Medical Center, Boca Raton, FL, USA
| | - Seetha Shankaran
- Department of Pediatrics, Wayne State University, Detroit, MI, USA
| | - Angelita M. Hensman
- Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI, USA
| | - Dwight J. Rouse
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Women and Infants Hospital, Brown University, Providence, RI, USA
| | - Scott McDonald
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle, NC, USA
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, USA
| | | | | | - Cynthia Gyamfi-Bannerman
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Elizabeth A. Thom
- Department of Biostatistics and Bioinformatics, George Washington University, Washington, DC, USA
| | - Rosemary D. Higgins
- Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | | | | |
Collapse
|
2
|
Neurological implications of antenatal corticosteroids on late preterm and term infants: a scoping review. Pediatr Res 2022; 92:1225-1239. [PMID: 35681094 DOI: 10.1038/s41390-022-02135-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/27/2022] [Accepted: 05/17/2022] [Indexed: 11/08/2022]
Abstract
The objective of this study was to synthesize the body of knowledge on the association between ACS exposure for risk of preterm birth and brain development in infants ultimately born late preterm and term. Three databases and eight conference proceedings were systematically searched (1972-2021). Selection criteria included ACS administration for risk of preterm delivery, cohort of late preterm and term infants, and assessment of brain development. Data on study characteristics, ACS administration, and neurological outcomes were extracted and qualitatively synthesized according to themes. Neurological outcomes of the included studies (n = 27) were grouped into four themes. The most common adverse outcomes were reduced neonatal head circumference, structural cortical differences on MRI, increased prevalence of psychiatric problems, and increased risk of neurodevelopmental delays in ACS-exposed late preterm and term infants. Our scoping review demonstrated that ACS exposure for risk of preterm delivery may have important neurological implications in infants ultimately born late preterm and term. Given that the existing research is at serious risk for bias, further research that accounts for confounders such as preterm labor, maternal stress, and the number of ACS courses is needed to better establish the long-term neurological effects of ACS on late preterm and term infants. IMPACT: Due to the difficulty in predicting preterm birth, approximately 40% of fetuses exposed to antenatal corticosteroids (ACS) are born at term (≥37 weeks' gestation). This scoping review summarizes the knowledge on the association between ACS exposure for risk of preterm birth and brain development in late preterm and term infants. The majority of studies reported that ACS exposure was associated with adverse brain development outcomes across various domains, such as reduced neonatal head circumference, cortical differences on MRI, and increased prevalence of psychiatric problems and neurodevelopmental delays in late preterm and term infants.
Collapse
|
3
|
Rittenschober-Böhm J, Rodger J, Jobe AH, Kallapur SG, Doherty DA, Kramer BW, Payne MS, Archer M, Rittenschober C, Newnham JP, Miura Y, Berger A, Matthews SG, Kemp MW. Antenatal Corticosteroid Exposure Disrupts Myelination in the Auditory Nerve of Preterm Sheep. Neonatology 2018; 114:62-68. [PMID: 29669335 DOI: 10.1159/000487914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/22/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Antenatal corticosteroids (ACS) improve preterm neonatal outcomes. However, uncertainty remains regarding the safety of ACS exposure for the developing fetus, particularly its neurosensory development. OBJECTIVES We investigated the effect of single and multiple ACS exposures on auditory nerve development in an ovine model of pregnancy. METHODS Ewes with a single fetus (gestational age [GA] 100 days) received an intramuscular injection of 150 mg medroxyprogesterone-acetate, followed by intramuscular (i) betamethasone (0.5 mg/kg) on days 104, 111, and 118 GA; (ii) betamethasone on day 104 and saline on days 111 and 118 GA; or (iii) saline on days 104, 111, and 118 GA, with delivery on day 125 GA. Transmission electron microscope images of lamb auditory nerve preparations were digitally analyzed to determine auditory nerve morphology and myelination. RESULTS Relative to the control, mean auditory nerve myelin area was significantly increased in the multiple-treatment group (p < 0.001), but not in the single-treatment group. Increased myelin thickness was significantly changed only in a subgroup analysis for those axons with myelin thickness greater than the median value (p < 0.001). Morphological assessments showed that the increased myelin area was due to an increased likelihood of decompacted areas (p = 0.005; OR = 2.14, 95% CI 1.26-3.63; 31.6 vs. 18.2% in controls) and irregular myelin deposition (p = 0.001; OR = 5.91, 95% CI 2.16-16.19; 49.0 vs. 16.8% in controls) in the myelin sheath. CONCLUSIONS In preterm sheep, ACS exposure increased auditory nerve myelin area, potentially due to disruption of normal myelin deposition.
Collapse
Affiliation(s)
- Judith Rittenschober-Böhm
- Division of Obstetrics and Gynaecology, UWA, Perth, Washington, Australia
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Jennifer Rodger
- Experimental and Regenerative Neurosciences, School of Biological Sciences, UWA, Perth, Washington, Australia
| | - Alan H Jobe
- Division of Pulmonary Biology, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio, USA
| | - Suhas G Kallapur
- Division of Pulmonary Biology, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio, USA
| | - Dorota A Doherty
- Division of Obstetrics and Gynaecology, UWA, Perth, Washington, Australia
| | - Boris W Kramer
- Department of Pediatrics, Maastricht University, Maastricht, the Netherlands
| | - Matthew S Payne
- Division of Obstetrics and Gynaecology, UWA, Perth, Washington, Australia
| | - Michael Archer
- Experimental and Regenerative Neurosciences, School of Biological Sciences, UWA, Perth, Washington, Australia
| | | | - John P Newnham
- Division of Obstetrics and Gynaecology, UWA, Perth, Washington, Australia
| | - Yuichiro Miura
- Division of Obstetrics and Gynaecology, UWA, Perth, Washington, Australia
| | - Angelika Berger
- Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Stephen G Matthews
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Matthew W Kemp
- Division of Obstetrics and Gynaecology, UWA, Perth, Washington, Australia
| |
Collapse
|
4
|
Anegroaie P, Frasch MG, Rupprecht S, Antonow-Schlorke I, Müller T, Schubert H, Witte OW, Schwab M. Development of somatosensory-evoked potentials in foetal sheep: effects of betamethasone. Acta Physiol (Oxf) 2017; 220:137-149. [PMID: 27580709 DOI: 10.1111/apha.12795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 06/15/2016] [Accepted: 08/30/2016] [Indexed: 11/30/2022]
Abstract
AIM Antenatal glucocorticoids are used to accelerate foetal lung maturation in babies threatened with premature labour. We examined the influence of glucocorticoids on functional and structural maturation of the central somatosensory pathway in foetal sheep. Somatosensory-evoked potentials (SEP) reflect processing of somatosensory stimuli. SEP latencies are determined by afferent stimuli transmission while SEP amplitudes reveal cerebral processing. METHODS After chronic instrumentation of foetal sheep, mothers received saline (n = 9) or three courses of betamethasone (human equivalent dose of 2 × 110 μg kg-1 betamethasone i.m. 24 h apart, n = 12) at 0.7, 0.75 and 0.8 of gestational age. Trigeminal SEP were evoked prior to, 4 and 24 h after each injection and at 0.8 of gestational age before brains were histologically processed. RESULTS Somatosensory-evoked potentials were already detectable at 0.7 of gestation age. The early and late responses N20 and N200 were the only reproducible peaks over the entire study period. With advancing gestational age, SEP latencies decreased but amplitudes remained unchanged. Acutely, betamethasone did not affect SEP latencies and amplitudes 4 and 24 h following administration. Chronically, betamethasone delayed developmental decrease in the N200 but not N20 latency by 2 weeks without affecting amplitudes. In parallel, betamethasone decreased subcortical white matter myelination but did not affect network formation and synaptic density in the somatosensory cortex. CONCLUSION Somatosensory stimuli are already processed by the foetal cerebral cortex at the beginning of the third trimester. Subsequent developmental decrease in SEP latencies suggests ongoing maturation of afferent sensory transmission. Antenatal glucocorticoids affect structural and functional development of the somatosensory system with specific effects at subcortical level.
Collapse
Affiliation(s)
- P. Anegroaie
- Department of Neurology; Jena University Hospital; Jena Germany
- Department of Pediatric Surgery; Jena University Hospital; Jena Germany
| | - M. G. Frasch
- Department of Obstetrics and Gynecology; University of Washington; Seattle WA USA
| | - S. Rupprecht
- Department of Neurology; Jena University Hospital; Jena Germany
| | | | - T. Müller
- Institute of Laboratory Animal Science; Jena University Hospital; Jena Germany
| | - H. Schubert
- Institute of Laboratory Animal Science; Jena University Hospital; Jena Germany
| | - O. W. Witte
- Department of Neurology; Jena University Hospital; Jena Germany
| | - M. Schwab
- Department of Neurology; Jena University Hospital; Jena Germany
| |
Collapse
|
5
|
Shany E, Berger I, Goldberg O, Karplus M, Gilat S, Benzaquen O, Yogev H, Shalev R. Do Prenatal Corticosteroids Affect Brain Maturation of the Premature Infant? An Electroencephalography Study. Clin EEG Neurosci 2017; 48:79-87. [PMID: 27090506 DOI: 10.1177/1550059416643202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess whether prenatal treatment with betamethasone has a significant influence on cerebral maturation indices as measured by electroencephalographic (EEG) indices. STUDY DESIGN Infants born less than 35 weeks postmenstrual age (PMA) were prospectively enrolled if their mother received a full course of bethametasone prior to delivery (study group) or not (control group); infants with major intracranial abnormalities were excluded as well as those who were sedated or needed assisted ventilation. EEG was recorded during the first 10 days of life. Interburst intervals and maximal amplitudes of theta and delta bandwidths were calculated by a signal processing software. A multivariate general linear model was used to analyze the relationship between the 2 groups and the different electrophysiologic parameters, adjusting for PMA and mode of delivery. RESULTS Thirty-eight infants were included in the study group and 36 in the control group. Univariate analysis demonstrated a negative correlation between PMA at test and EEG indices (interburst interval and delta and theta frequencies). Multivariate analysis demonstrated a less robust correlation of PMA and EEG indices and a positive correlation of prenatal betamethasone treatment with Theta frequencies. Repeating the data analysis separately for each study group, the above results remained significant mainly in the study group. CONCLUSIONS Our findings suggest a possible stabilization effect of corticosteroids on the central nervous system and a possible delay of the maturation of cerebral activity related to prenatal corticosteroids use. These findings may relate to a better neurodevelopmental outcome of infants treated prenatally with corticosteroids.
Collapse
Affiliation(s)
- Eilon Shany
- 1 Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.,2 Neonatal Department, Soroka Medical Center, Beer Sheva, Israel
| | - Itai Berger
- 3 Neuro-Cognitive Center, Pediatric Wing, Hadassah-Hebrew University Medical Center (Mt. Scopus Campus), Jerusalem, Israel
| | - Ori Goldberg
- 4 Pediatric Department, Shneider Children Hospital, Petah Tikwa, Israel
| | - Michael Karplus
- 1 Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Shlomo Gilat
- 5 S. Gilat Medical Research & Equipment Ltd, Karkur, Israel
| | - Oshra Benzaquen
- 6 Radiology Department, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel
| | - Hagai Yogev
- 7 Tel Aviv-Yaffo Academic College, Tel Aviv-Yaffo, Israel
| | - Ruth Shalev
- 8 Neuropaediatric Unit, Shaare Zedek Medical Centre, Jerusalem, Israel
| |
Collapse
|
6
|
Babović I, Radojičić Z, Plešinac S, Kastratović Kotlica B, Sparić R. Direct intramuscular fetal or maternal antenatal corticosteroid therapy: short-time effects on fetal behavior and oxygenation: a comparative study. J Matern Fetal Neonatal Med 2015; 29:3213-7. [PMID: 26572588 DOI: 10.3109/14767058.2015.1121229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare the effects of antenatal administration of corticosteroids used in two different regimens, on fetal biophysical profile (BPP), baseline fetal heart rate (BFHR), nonstress test (NST) and perinatal outcomes. STUDY DESIGN We evaluated the effects of single direct intramuscular (i.m.) fetal dose of dexamethasone (4 mg/kg), or four doses of 6 mg dexamethasone given to the mother 12 hours apart on the parameters of fetal BPP 0-4 hours before and after antenatal contraction stress (ACST). We evaluated two groups of 41 fetuses in the 31st gestation week at risk of fetal hypoxia at the Department of Gynecology/Obstetrics, Clinical Center of Serbia in 2013. RESULTS In fetal ACST group, we found significantly different changes in fetal breathing movement before (D0-f) and after therapy (D1-f), p = 0.019 (-11.75; -1.12), 95% confidence interval (CI), as well as in the maternal ACST group, p = 0.001; (-11.75; -1.12), 95% CI. We found significant difference between BPP 0-m and BPP1-m in the maternal group, p = 0.000. Neonatal asphyxia occurred more often with the increased frequency of fetal breath movements after both ACST (p = 0.04 versus p = 0.07). CONCLUSION Fetal ACST results in increased fetal breathing movements. Maternal ACST can result in changes to BPP. The increase in fetal breathing movements determinates neonatal asphyxia regardless of the ACST.
Collapse
Affiliation(s)
- Ivana Babović
- a Department of Gynecology and Obstetrics , Clinical Center of Serbia, School of Medicine, University of Belgrade , Belgrade , Serbia
| | - Zoran Radojičić
- b Faculty of Organizational Sciences , Institute for Statistics, University of Belgrade , Belgrade , Serbia , and
| | - Snežana Plešinac
- a Department of Gynecology and Obstetrics , Clinical Center of Serbia, School of Medicine, University of Belgrade , Belgrade , Serbia
| | - Biljana Kastratović Kotlica
- a Department of Gynecology and Obstetrics , Clinical Center of Serbia, School of Medicine, University of Belgrade , Belgrade , Serbia
| | - Radmila Sparić
- c Department of Gynecology and Obstetrics , Clinical Center of Serbia , Belgrade , Serbia
| |
Collapse
|
7
|
Braun T, Challis JR, Newnham JP, Sloboda DM. Early-life glucocorticoid exposure: the hypothalamic-pituitary-adrenal axis, placental function, and long-term disease risk. Endocr Rev 2013; 34:885-916. [PMID: 23970762 DOI: 10.1210/er.2013-1012] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
An adverse early-life environment is associated with long-term disease consequences. Adversity early in life is hypothesized to elicit developmental adaptations that serve to improve fetal and postnatal survival and prepare the organism for a particular range of postnatal environments. These processes, although adaptive in their nature, may later prove to be maladaptive or disadvantageous if the prenatal and postnatal environments are widely discrepant. The exposure of the fetus to elevated levels of either endogenous or synthetic glucocorticoids is one model of early-life adversity that contributes substantially to the propensity of developing disease. Moreover, early-life glucocorticoid exposure has direct clinical relevance because synthetic glucocorticoids are routinely used in the management of women at risk of early preterm birth. In this regard, reports of adverse events in human newborns have raised concerns about the safety of glucocorticoid treatment; synthetic glucocorticoids have detrimental effects on fetal growth and development, childhood cognition, and long-term behavioral outcomes. Experimental evidence supports a link between prenatal exposure to synthetic glucocorticoids and alterations in fetal development and changes in placental function, and many of these alterations appear to be permanent. Because the placenta is the conduit between the maternal and fetal environments, it is likely that placental function plays a key role in mediating effects of fetal glucocorticoid exposure on hypothalamic-pituitary-adrenal axis development and long-term disease risk. Here we review recent insights into how the placenta responds to changes in the intrauterine glucocorticoid environment and discuss possible mechanisms by which the placenta mediates fetal hypothalamic-pituitary-adrenal development, metabolism, cardiovascular function, and reproduction.
Collapse
Affiliation(s)
- Thorsten Braun
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, 1280 Main Street West, HSC 4H30A, Hamilton, Ontario, Canada L8S 4K1.
| | | | | | | |
Collapse
|
8
|
Davis EP, Sandman CA, Buss C, Wing DA, Head K. Fetal glucocorticoid exposure is associated with preadolescent brain development. Biol Psychiatry 2013; 74:647-55. [PMID: 23611262 PMCID: PMC3985475 DOI: 10.1016/j.biopsych.2013.03.009] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 03/11/2013] [Accepted: 03/13/2013] [Indexed: 01/04/2023]
Abstract
BACKGROUND Glucocorticoids play a critical role in normative regulation of fetal brain development. Exposure to excessive levels may have detrimental consequences and disrupt maturational processes. This may especially be true when synthetic glucocorticoids are administered during the fetal period, as they are to women in preterm labor. This study investigated the consequences for brain development and affective problems of fetal exposure to synthetic glucocorticoids. METHODS Brain development and affective problems were evaluated in 54 children (56% female), aged 6 to 10, who were full term at birth. Children were recruited into two groups: those with and without fetal exposure to synthetic glucocorticoids. Structural magnetic resonance imaging scans were acquired and cortical thickness was determined. Child affective problems were assessed using the Child Behavior Checklist. RESULTS Children in the fetal glucocorticoid exposure group showed significant and bilateral cortical thinning. The largest group differences were in the rostral anterior cingulate cortex (rACC). More than 30% of the rACC was thinner among children with fetal glucocorticoid exposure. Furthermore, children with more affective problems had a thinner left rACC. CONCLUSIONS Fetal exposure to synthetic glucocorticoids has neurologic consequences that persist for at least 6 to 10 years. Children with fetal glucocorticoid exposure had a thinner cortex primarily in the rACC. Our data indicating that the rACC is associated with affective problems in conjunction with evidence that this region is involved in affective disorders raise the possibility that glucocorticoid-associated neurologic changes increase vulnerability to mental health problems.
Collapse
Affiliation(s)
- Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, Colorado; Departments of Psychiatry and Human Behavior, University of California Irvine, Orange, California.
| | | | | | | | | |
Collapse
|
9
|
Functional plasticity before the cradle: a review of neural functional imaging in the human fetus. Neurosci Biobehav Rev 2013; 37:2220-32. [PMID: 23542738 DOI: 10.1016/j.neubiorev.2013.03.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 03/13/2013] [Accepted: 03/20/2013] [Indexed: 01/17/2023]
Abstract
The organization of the brain is highly plastic in fetal life. Establishment of healthy neural functional systems during the fetal period is essential to normal growth and development. Across the last several decades, remarkable progress has been made in understanding the development of human fetal functional brain systems. This is largely due to advances in imaging methodologies. Fetal neuroimaging began in the 1950-1970's with fetal electroencephalography (EEG) applied during labor. Later, in the 1980's, magnetoencephalography (MEG) emerged as an effective approach for investigating fetal brain function. Most recently, functional magnetic resonance imaging (fMRI) has arisen as an additional powerful approach for examining fetal brain function. This review will discuss major developmental findings from fetal imaging studies such as the maturation of prenatal sensory system functions, functional hemispheric asymmetry, and sensory-driven neurodevelopment. We describe how with improved imaging and analysis techniques, functional imaging of the fetus has the potential to assess the earliest point of neural maturation and provide insight into the patterning and sequence of normal and abnormal brain development.
Collapse
|
10
|
Surbek D, Drack G, Irion O, Nelle M, Huang D, Hoesli I. Antenatal corticosteroids for fetal lung maturation in threatened preterm delivery: indications and administration. Arch Gynecol Obstet 2012; 286:277-81. [DOI: 10.1007/s00404-012-2339-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 04/13/2012] [Indexed: 11/29/2022]
|
11
|
Moraru L, Sameni R, Schneider U, Haueisen J, Schleußner E, Hoyer D. Validation of fetal auditory evoked cortical responses to enhance the assessment of early brain development using fetal MEG measurements. Physiol Meas 2011; 32:1847-68. [DOI: 10.1088/0967-3334/32/11/002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|