Neurobehavior in Term, Small-for-Gestational Age Infants With Normal Placental Function

Figueras, F.; Orós, Daniel; Cruz‐Martínez, R.; Padilla, Nelly; Hernández‐Andrade, Edgar; Botet, Francesc; Costas-Moragas, Carme; Gratacós, Eduard

doi:10.1542/peds.2008-3346

Cited by 115 publications

(116 citation statements)

References 54 publications

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“…Fetuses with an expected fetal weight below 10th centile but normal Doppler in the UA are generally considered as constitutional normally small fetuses. Recent publications highlight that within this group there are some cases having an abnormal perinatal outcome [20,21]. Clearly, this is a heterogeneous group and additional fetal hemodynamic parameters should be evaluated.…”

Section: Discussionmentioning

confidence: 99%

Changes in Central and Peripheral Circulation in Intrauterine Growth-Restricted Fetuses at Different Stages of Umbilical Artery Flow Deterioration: New Fetal Cardiac and Brain Parameters

Benavides-Serralde

Scheier²,

Cruz‐Martínez³

et al. 2011

Gynecol Obstet Invest

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Objective: To evaluate changes in central and peripheral circulation, including new and standard parameters of the fetal brain and heart in fetuses with intrauterine growth restriction (IUGR) in relation to progressive deterioration of the umbilical artery (UA). Methods: Seventy-two IUGR fetuses were studied longitudinally. IUGR was defined as an estimated fetal weight <10th centile for gestational age. Fetuses were classified according the UA pulsatility index (PI) as: group 1, normal UA-PI (<95th centile; <1.645 z-scores), group 2, UA-PI (≧95th centile and <99th centile; ≧1.645 and <3 z-scores), group 3, UA absent end-diastolic flow, and group 4, UA reversed end-diastolic flow. Middle cerebral artery (MCA), anterior cerebral artery segments 1 (ACA1) and 2 (ACA2), aortic isthmus blood flow index (IFI), modified myocardial performance index (Mod-MPI), ductus venosus (DV), renal artery (RA), femoral artery (FA) and amniotic fluid index (AFI) were weekly evaluated until delivery. Results: A total of 263 scans were performed (median, 3 (range: 1–23) per patient). There were 6 intrauterine and 2 neonatal deaths. Although all cerebral arteries showed a reduction in the PI, ACA1 showed the earliest vasodilatation. From group 2 onwards, all cerebral vessels had a similar pattern of vasodilatation. Mod-MPI became abnormal at group 1 with no further changes. IFI and DV became constantly abnormal starting from group 2. No changes in the RA-PI or FA-PI were documented. Conclusion: The process of hemodynamic deterioration in IUGR fetuses seems to be earlier represented by the ACA1 and the Mod-MPI. Signs of further deterioration were observed in the DV, IFI and MCA. The peripheral blood in the RA and FA did not show any change. AFI showed a late deterioration process.

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Section: Discussionmentioning

confidence: 99%

Changes in Central and Peripheral Circulation in Intrauterine Growth-Restricted Fetuses at Different Stages of Umbilical Artery Flow Deterioration: New Fetal Cardiac and Brain Parameters

Benavides-Serralde

Scheier²,

Cruz‐Martínez³

et al. 2011

Gynecol Obstet Invest

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“…A deficient state organization and regulation was found in SGA newborns, suggesting a delay in neurological maturation) (Figueras et al, 2009). However, this discrepancy must be qualified, because significant differences have been found in two items (Response Decrement Light and General Tone), confirming the worse performance of SGA newborns.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have analyzed LBW but neglected the GA or indistinctly used LBW and prematurity (Davis et al, 2007;Ohgi et al, 2003). Other research has demonstrated that the LBW, per se, taken separately from prematurity, is also a risk factor and has highlighted that SGA full term babies perform worse in neurobehavioral tests than neonates of an adequate birthweight (Costas-Moragas, 2009;Figueras et al, 2009).…”

Section: *) Introductionmentioning

confidence: 99%

Neurobehavioral conditions and effects of gender, weight and severity in preterm infants according to the Neonatal Behavioral Assessment Scale

et al. 2015

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Título: Efecto del sexo, peso y gravedad de la prematuridad en el neurocomportamiento de recién nacidos prematuros a través de la Neonatal Behavioral Assessment Scale. Resumen: El aumento de los recién nacidos prematuros en los últimos años hace que se incremente el interés por estudiar las consecuencias de este factor de riesgo. En este trabajo se evalúan 30 prematuros (a las 40 semanas de edad gestacional) con la Escala para la Evaluación del Comportamiento Neonatal de Brazelton y se comparan sus resultados con los de un grupo control formado por 28 neonatos a término. Así mismo se comparan dentro del grupo de prematuros el efecto del peso, el sexo y la gravedad de la prematuridad. Los controles muestran superioridad en 9 de los 28 ítems comportamentales de la Escala y en dos de las 5 categorías. Los prematuros muestran superioridad en Habituación. Las niñas muestran mejor ejecución en la categoría Social-Interactiva. Los prematuros se ven afectados por la abrupta interrupción de su maduración intrauterina. Aunque podría haber un efecto de aprendizaje debido a la exposición extrauterina. Palabras clave: Neonatal Behavioral Assessment Scale; NBAS; prematuridad; neuroconducta neonatal; evaluación desarrollo neonatal. Abstract:The increasing number of preterm babies in recent years has raised interest in studying the consequences of prematurity as a risk factor. In the present paper, 30 preterm babies (at 40 weeks of gestational age) were assessed using the Neonatal Behavioral Assessment Scale and the results were compared with those of a control group of 28 full term babies. Moreover, the influence of weight, sex and gestational age was analyzed considering the Brazelton results in the preterm group. The preterm group showed significantly lower scores than the control group for 9 of the 28 behavioral items in the Scale and for 2 of the 5 clusters. However, preterm babies performed better in habituation to disturbing stimuli (light and noise) during sleep. In relation to the influence of sex, premature girls performed better in the Social-Interactive cluster. The preterm group has lower neurobehavioral conditions than the full term group, probably due to the abrupt interruption of their intrauterine maturation. In contrast, they showed a better ability of habituation, maybe as a consequence of a learning effect due to earlier additional extrauterine exposition.

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“…Sanz-Cortes et al (2010) [9] FGR fetuses with normal umbilical PI matched with AGA controls were studied by functional MRI at 37 weeks to measure markers of brain microstructure and metabolism. [67] Evaluation of neurobehavioral outcomes of term FGR with normal UmA-PI.…”

Section: Middle Cerebral Arterymentioning

confidence: 99%

“…In addition, in a subset of other late FGR environmental factors might play a major role in determining growth restriction, such as heavy maternal smoking [66], poor maternal nutrition [13], and others. Thorough consideration of these diagnostic criteria could be helpful in proper definition of FGR versus SGA, important differentiation as supported by the analysis of perinatal outcomes [67,68]. In the longitudinal post-natal studies by Figueras et al, SGA was defined based on the inclusion criteria.…”

Section: Late Onset and Term Fetal Growth Restrictionmentioning

confidence: 99%

Fetal Growth Restriction (FGR)—Fetal Evaluation and Antepartum Intervention

Ferrazzi

Stampalija

Makarenko

et al. 2013

Curr Obstet Gynecol Rep

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Fetal growth restriction (FGR) is a pathological condition that refers to a fetus that fails to reach his/her genetically predetermined growth potential. By epigenetic effects, substrate and energy deprivation in utero modify fetal metabolism with possible life-long impacts. Management of FGR still represents one of the main challenges for the obstetricians, both for the complexities of management of severe early FGR and for the diagnostic difficulties in late and term FGR. Late onset and term FGR define an intrauterine trajectory of growth that falls below its potential late in gestation, after 34 and 37 weeks of gestation, respectively. Ultrasound biometry examination is crucial for an accurate diagnosis of FGR. Pregnancies at risk of FGR should be considered for longitudinal ultrasound monitoring beyond the routine ultrasound screening at 20 weeks of gestation. Functional assessment of placental and fetal circulation by Doppler velocimetry and blood flow volume, together with computerized assessment of fetal heart rate variability, are key examinations in early and late FGR to assess severity of the disease and monitor fetal wellbeing. Appropriate timing of delivery in early FGR might change the outcome, and appropriate monitoring in late and term FGR might avoid unnecessary interventions.

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Neurobehavior in Term, Small-for-Gestational Age Infants With Normal Placental Function

Abstract: Term SGA newborns with no signs of placental insufficiency had poorer neurobehavioral competencies, which suggests delayed neurologic maturation.

Cited by 115 publications

References 54 publications

Changes in Central and Peripheral Circulation in Intrauterine Growth-Restricted Fetuses at Different Stages of Umbilical Artery Flow Deterioration: New Fetal Cardiac and Brain Parameters

Changes in Central and Peripheral Circulation in Intrauterine Growth-Restricted Fetuses at Different Stages of Umbilical Artery Flow Deterioration: New Fetal Cardiac and Brain Parameters

Neurobehavioral conditions and effects of gender, weight and severity in preterm infants according to the Neonatal Behavioral Assessment Scale

Fetal Growth Restriction (FGR)—Fetal Evaluation and Antepartum Intervention

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