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Fetal neurosonographic assessment of cortical development in late-onset Fetal growth restriction and small for gestational age fetuses

Journal of Perinatology (2026)Cite this article

Subjects

Abstract

Objective

To evaluate whether late-onset fetal growth restriction (LO-FGR) is associated with distinct alterations in cortical sulcation and midline brain structures compared with small-for-gestational-age (SGA) and appropriately grown (AGA) fetuses, and to examine how these changes relate to cerebroplacental redistribution.

Study design

This prospective cross-sectional study included 84 LO-FGR, 64 SGA, and 120 AGA fetuses examined between 32 and 36 weeks’ gestation. Targeted neurosonography assessed cortical sulcation, corpus callosum length, and cranio-cortical width, together with Doppler evaluation of the cerebroplacental ratio (CPR).

Results

LO-FGR fetuses demonstrated shallower Sylvian fissures, shorter corpus callosum length, increased insular depth, and wider lateral cranio-cortical width compared with both SGA and AGA fetuses (all p < 0.001). These neurosonographic differences were more pronounced in the presence of abnormal CPR.

Conclusion

LO-FGR is associated with specific cortical and midline brain alterations distinct from both SGA and AGA, with the severity of these changes modulated by cerebroplacental redistribution.

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Data availability

Data supporting the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Perinatology, Liv Hospital Ulus, İstanbul, Turkey

    Miraç Özalp

  2. Department of Obstetrics and Gynecology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey

    Murat İbrahim Toplu

  3. Department of Obstetrics and Gynecology, Mogadishu Somalia – Türkiye Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia

    Murat İbrahim Toplu

Authors
  1. Miraç Özalp
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  2. Murat İbrahim Toplu
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Contributions

Miraç Özalp: Conceptualization; Methodology; Investigation; Data curation; Resources; Validation; Writing – review & editing; Supervision. Murat İbrahim Toplu: Methodology; Data curation; Formal analysis; Software; Writing – original draft; Writing – review & editing; Visualization; Project administration.

Corresponding author

Correspondence to Murat İbrahim Toplu.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Institutional Review Board of Prof. Dr. Cemil Taşcıoğlu City Hospital (Approval No: 2024/69; Date: 01.04.2024). Written INFORMED consent was obtained from all participants prior to inclusion in the study.

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Özalp, M., Toplu, M.İ. Fetal neurosonographic assessment of cortical development in late-onset Fetal growth restriction and small for gestational age fetuses. J Perinatol (2026). https://doi.org/10.1038/s41372-026-02638-5

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