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.