Abnormal antenatal Doppler velocimetry and cognitive outcome in very‐low‐birth‐weight infants at 2 years of age

Leppänen, Marika; Ekholm, Eeva; Palo, Pertti; Maunu, Jonna; Munck, Petriina; Parkkola, Riitta; Matomäki, Jaakko; Lapinleimu, Helena; Haataja, Leena; Lehtonen, Liisa; Rautava, Päivi

doi:10.1002/uog.7694

Cited by 36 publications

(51 citation statements)

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“…Nevertheless, the same differences could not be documented at 11 years of age [27]. Leppanen et al [28] followed a group of very low birth weight infants until 2 years of age and found that abnormal neurological outcome was significantly associated with abnormal fetal MCA-PI; however, after adjusting for brain volume no significant association was longer observed. The conclusion was that intracranial Doppler parameters are related to the intracranial volume, and that reduced cranial volume has a higher association with abnormal neurological outcome.…”

Section: Early and Progressive Intrauterine Growth Restrictionmentioning

confidence: 84%

Cerebral blood flow studies in the diagnosis and management of intrauterine growth restriction

Hernández‐Andrade

Stampalija

Figueras

2013

Current Opinion in Obstetrics &Amp; Gynecology

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Changes in cerebral brain blood perfusion in IUGR fetuses can be detected by Doppler ultrasound techniques. Despite its association with structural and functional neurological damage after birth, fetal brain vasodilatation is usually not considered in the decision to deliver, with the only exception of the 'return' to normal middle cerebral artery pulsatility index, which is highly associated with an increased risk for perinatal mortality.

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Section: Early and Progressive Intrauterine Growth Restrictionmentioning

confidence: 84%

Cerebral blood flow studies in the diagnosis and management of intrauterine growth restriction

Hernández‐Andrade

Stampalija

Figueras

2013

Current Opinion in Obstetrics &Amp; Gynecology

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“…In addition, no significant rise in major neonatal complications was depicted [25]. Conversely, it was also reported that neonates with EO-FGR and abnormal UA PI and brain vasodilatation had a significantly lower neurological performance than neonates with abnormal UA PI but without brain vasodilatation [28]. Further elaboration of findings of some studies that associated abnormal neurologic outcome and abnormal fetal MCA PI revealed no longer significant association after adjusting for brain volume [27].…”

Section: Discussionmentioning

confidence: 99%

The Disappearing Brain-Sparing Effect in Early-Onset Fetal Growth Restriction Fetuses Revisited

Yeniel

Ergenoğlu²,

Sanhal³

et al. 2013

Fetal Diagn Ther

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Objective: To evaluate the association between the brain-sparing situation and perinatal outcomes in fetuses with early-onset fetal growth restriction (EO-FGR) with absent or reverse end-diastolic flow in the umbilical artery (UA A/REDF). Methods: We evaluated fetuses with EO-FGR who had patterns of UA A/REDF without abnormal venous Doppler indices. Participants were divided into two groups according to measurements of mid-cerebral artery pulsatility index (MCA PI) just before delivery. Group 1 (n = 45) included those with a brain-sparing effect (BSE) (a MCA PI <5th percentile for the gestational age) and group 2 (n = 14) included those with a disappearing BSE, defined as an MCA PI increase towards normal values after the BSE detected at the initial evaluation. Short-term perinatal outcomes were analyzed. Results: Compared to group 1, group 2 had a significantly low birth weight (p = 0.018) and high rates of extended neonatal intensive care unit hospitalization (p = 0.049 respectively). Conclusion: On the basis of longitudinal measurements of MCA PI, increases after the reduction <5th percentile might be related to poor perinatal outcomes in fetuses with EO-FGR who had UA A/REDF without abnormal venous flow patterns.

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“…There were 274 infants who met our inclusion criteria; they were born between 2001 and 2006 with a birth weight ,1501 g or between 2004 and 2006 with a gestational age (GA) ,32 weeks (very low GA), treated at Turku University Hospital, and from Finnishor Swedish-speaking families living in the catchment area to enable psychological assessment. 33 Infants with severe congenital anomalies or a diagnosed syndrome affecting their development were excluded. Forty-one (15%) died, 9 (4%) of the families refused to participate, and the number of later dropouts was 23 (10%).…”

Section: Study Subjectsmentioning

confidence: 99%

Antenatal and Postnatal Growth and 5-Year Cognitive Outcome in Very Preterm Infants

Leppänen

Lapinleimu

Lind³

et al. 2014

Pediatrics

105

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WHAT'S KNOWN ON THIS SUBJECT: Better postnatal growth, especially head growth, associates with better cognitive development in preterm infants. Suboptimal postnatal growth is more common in infants with poor antenatal growth than in infants with normal growth. WHAT THIS STUDY ADDS:Good weight gain and head circumference growth until 2 years was associated with better 5-year cognitive outcome in non-small for gestational age infants. Good head circumference growth around term age benefits the cognitive outcome of small for gestational age infants. abstract OBJECTIVES: To study how antenatal growth affects cognitive outcome in very preterm infants and to determine whether there is an association between growth in any particular time period between birth and 5 years of age and cognitive outcome. Small for gestational age (SGA) and non-SGA infants were analyzed separately, because antenatal growth may affect postnatal growth. and 2006 who were treated at Turku University Hospital (n = 181) were followed. Weight, length, and head circumference (HC) of the infants were measured at 9 time points between birth and 5 years. The growth was determined as a z score change between measurement points. Cognitive development was assessed at 5 years of age with the Wechsler Preschool and Primary Scales of IntelligenceRevised. The association between growth and full-scale IQ (FSIQ) was studied. METHODS:RESULTS: Growth in length and height was not associated with 5-year cognitive outcome. However, weight (r = 0.18, P = .04) and HC growth (r = 0.25, P = .01) between birth and 2 years of corrected age correlated to FSIQ in non-SGA children. In SGA children, HC growth (r = 0.33, P = .03) around term age correlated to FSIQ. CONCLUSIONS:Cognitive outcome was similar in SGA and non-SGA very preterm infants. Growth affected cognition positively in both subgroups, but the critical time period was different. Drs Leppänen and Lind made substantial contributions to conception and design, acquired data, analyzed and interpreted data, and wrote and revised the manuscript; Drs Lapinleimu, Lehtonen, Haataja, and Rautava made substantial contributions to conception and design, analyzed and interpreted data, and wrote and revised the manuscript; Mr Matomäki carried out the statistical analyses, made substantial contributions to conception and design and interpretation of data, and wrote and revised the manuscript; and all authors approved the article to be published. www.pediatrics.org/cgi

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Abnormal antenatal Doppler velocimetry and cognitive outcome in very‐low‐birth‐weight infants at 2 years of age

Abstract: Objective To study neurodevelopmental outcome at 2 years of corrected age in very-low-birth-weight (VLBW) (≤ 1500 g) preterm infants with abnormal fetoplacental flow. Methods

Cited by 36 publications

References 50 publications

Cerebral blood flow studies in the diagnosis and management of intrauterine growth restriction

Cerebral blood flow studies in the diagnosis and management of intrauterine growth restriction

The Disappearing Brain-Sparing Effect in Early-Onset Fetal Growth Restriction Fetuses Revisited

Antenatal and Postnatal Growth and 5-Year Cognitive Outcome in Very Preterm Infants

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