Fetal Mild Ventriculomegaly Detected In Utero by Ultrasound: A Risk Factor for Schizophrenia?




JH Gilmore*, J

van Tol, HL Streicher, K. Williamson, SB Cohen, R. Greenwood, CR

Charles, MA Kliewer, JK Whitt, SG Silva, BS Hertzberg NC

Chescheir. Department of Psychiatry, University of North Carolina

School of Medicine.

The most consistent structural

abnormality of the brain associated with schizophrenia is that of

mild enlargement of the lateral cerebral ventricles. Mild

ventriculomegaly (MVM) of the fetal brain detected in utero

with ultrasound is associated with developmental delays similar

to those described in children at high risk for schizophrenia.

Fetal MVM may be a marker for increased risk of schizophrenia and

other neurodevelopmental abnormalities. To explore associations

between mild ventriculomegaly and obstetric complications and

demographic variables, 51 pregnancies in which the fetus

exhibited mild ventriculomegaly or routine ultrasonography and 49

control pregnancies were reviewed. Mothers of children with MVM

were older than controls and had shorter gestations. There were

no significant between-group differences in numbers of pregnancy

complications or pregnancy outcomes as reflected in gestational

age at birth, birthweight, or APGAR scores. Children with

isolated MVM tended to be male. These findings indicate that

isolated MVM detected in utero is not associated with

pregnancy complications and suggests that isolated mild

ventriculomegaly of the fetus is genetically determined or caused

by environmental events not routinely considered pregnancy

complications. The outcome of six children (ages 4-9 years) with

fetal MVM was determined. One had attention deficit disorder, one

had autism, and two had evidence of learning disorders. Three

children underwent follow-up MRI, two children with evidence of a

learning disorder had mildly enlarged, asymmetric ventricles.

This indicates that mild ventriculomegaly detected in utero with

ultrasound can persist into childhood and that MVM may marker or

risk factor for subsequent neurodevelopmental abnormalities.