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Sexual dimorphism of the fetal brain biometry: an MRI-based study

  • Maternal-Fetal Medicine
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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Abstract

Purpose

Fetal growth assessment is a key component of prenatal care. Sex-specific fetal brain nomograms on ultrasound are available and are clinically used. In recent years, the use of fetal MRI has been increasing; however, there are no sex-specific fetal CNS nomograms on MRI. The study aimed to assess the differences in fetal brain biometry and growth trajectories and to create population-based standards of the fetal brain on MRI.

Methods

In this cross-sectional study, brain structures of singleton fetuses with normal brain MRI scans were analyzed: biparietal diameter, occipitofrontal diameter, trans-cerebellar diameter, and the corpus callosum were measured and converted into centiles. Sex-specific nomograms were created.

Results

A total of 3848 MRI scans were performed in one tertiary medical center between 2011 and 2019; of them, 598 fetuses met the inclusion criteria, 300 males and 298 females between 28- and 37-weeks’ gestation. Males had significantly larger occipitofrontal diameter than females (median 75%, IQR 54–88%; median 61%, IQR 40–77%) and biparietal diameter (median 63%, IQR 42–82%; median 50%, IQR 25–73%), respectively (p < 0.001). The cerebellum had the greatest growth rate, with a 1.5-fold increase in diameter between 28 and 37 weeks’ gestation, with no measurement difference between the sexes (p = 0.239). No significant difference was found in the corpus callosum (p = 0.074).

Conclusion

Measuring both sexes on the same nomograms may result in over-estimation of male fetuses and under-estimation of females. We provide fetal sex-specific nomograms on two-dimensional MRI.

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Abbreviations

BPD:

Biparietal diameter

OFD:

Occipitofrontal diameter

TCD:

Trans-cerebellar diameter

CC:

Corpus callosum

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Michal Gafner & Eldad Katorza

  2. Department of Pediatrics B, Schneider Children’s Medical Center of Israel, Kaplan 14, Petach Tikva, Israel

    Michal Gafner

  3. Faculty of Health Sciences, Joyce and Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Eliel Kedar Sade

  4. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Samson Assuta Ashdod Hospital, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Eran Barzilay

  5. Department of Diagnostic Radiology, Sheba Medical Center, Ramat-Gan, Israel

    Eldad Katorza

  6. Gertner Institute for Epidemiology and Health Policy, Sheba Medical Center, Ramat-Gan, Israel

    Eldad Katorza

Authors
  1. Michal Gafner
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  2. Eliel Kedar Sade
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  3. Eran Barzilay
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  4. Eldad Katorza
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Contributions

All authors contributed to the study's conception and design. Material preparation, data collection, and analysis were performed by MG, EK-S, EB, and EK. The first draft of the manuscript was written by MG and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Michal Gafner.

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Gafner, M., Kedar Sade, E., Barzilay, E. et al. Sexual dimorphism of the fetal brain biometry: an MRI-based study. Arch Gynecol Obstet 308, 1257–1262 (2023). https://doi.org/10.1007/s00404-022-06818-4

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  • DOI: https://doi.org/10.1007/s00404-022-06818-4

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