Feraz N. Rahman MS, Presenter: Nothing to Disclose

Jeffrey Keith Smith MD, PhD, Abstract Co-Author: Nothing to Disclose

Robert M Hamer DPHIL, Abstract Co-Author: Nothing to Disclose

Guido Gerig, Abstract Co-Author: Nothing to Disclose

Weili Lin PhD, Abstract Co-Author: Nothing to Disclose

John H. Gilmore MD, Abstract Co-Author: Research grant, GlaxoSmithKline plc

In previous studies, we found that 26% of neonates delivered vaginally had small intracranial hemorrhages (ICH), and that neonates with ICH had altered brain development, with larger brains and ventricles at 1 year. No neonates born by cesarean(C) section had ICH. The purpose of this study was to test whether there are brain development differences between neonates delivered by C-section versus those delivered vaginally.

Subjects and Imaging: Pregnant women were recruited for a prospective HIPAA-compliant study of neonatal brain development. After parental informed consent, neonates were imaged with 3.0 Tesla magnetic resonance (MR) imaging without sedation. The babies in the study were followed and had identical followup MRI scans at 1 year of age. Analysis: The healthy neonates were divided into two groups based on delivery method. In the vaginal delivery group, there were 24 subjects. In the C-section group, there were 7. Both groups were comparable for gender, gestational age at birth, gestational age at MRI, maternal age, race, maternal education, and prenatal ventricular size. For both groups, 1-year scans were segmented to examine the variables of total brain tissue volume, cortical gray matter volume, cerebellar volume, and ventricular volume. These measures were compared between the 2 groups.

Brain tissue volumes for C-section and vaginal delivery groups were mean ± standard deviation = 883 ± 109 and 859 ± 92 cm3, respectively. Cortical gray matter volumes were 521 ± 60 and 512 ± 49 cm3. Cerebellar volumes were 97 ± 12 and 92 ± 10 cm3. Ventricular volumes were 8.9 ± 5.7 and 7.6 ± 4.1 cm3.

These preliminary results show that there are no differences in volumes of brain tissue, cortical gray matter, cerebellum, or ventricles between the C-section and vaginal delivery groups. This result shows that the developmental differences in neonates with ICH were likely related solely to hemorrhage rather than the method of delivery.

This data shows that there are no major differences in brain size at 1 year between neonates delivered vaginally and those delivered by cesarean section.

Rahman, F, Smith, J, Hamer, R, Gerig, G, Lin, W, Gilmore, J, Cesarean Section versus Vaginal Delivery: No Differences in Brain Size at One Year.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6019690.html