Document Detail


Neurobehavioral outcomes in preterm, growth-restricted infants with and without prenatal advanced signs of brain-sparing.
MedLine Citation:
PMID:  21557369     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the neurobehavioral outcomes of preterm infants with intrauterine growth restriction (IUGR), with and without advanced brain-sparing in the middle cerebral artery (MCA) Doppler. PATIENT AND METHODS: A cohort of IUGR fetuses (birthweight<10(th) centile) born before 34 weeks with abnormal umbilical artery Doppler was created and compared to a control group of appropriate-for-gestational age infants matched by gestational age at delivery. MCA pulsatility index was measured in all cases within 72 hours of delivery. Neonatal neurobehavior was evaluated at 40-week ( ± 1) corrected age with the Neonatal Behavioral Assessment Scale. The effect of abnormal MCA pulsatility index (<5(th) centile) on each neurobehavioral area was adjusted for smoking, socioeconomic level, mode of delivery, gestational age at delivery, preeclampsia, newborn illness severity score and infant sex, by multiple linear and logistic regression. RESULTS: A total of 126 preterm newborns (62 controls and 64 IUGR) were included. Among IUGR fetuses, the proportion of abnormal MCA was 55%. Compared to appropriate-for-gestational age infants, newborns in the IUGR subgroup with abnormal MCA Doppler had significantly lower neurobehavioral scores in the areas of habituation, motor, social-interactive and attention. Similarly, the proportion of infants with abnormal neurobehavioral scores was significantly higher in the IUGR subgroup with abnormal MCA Doppler in the areas of habituation, social-interactive, motor, and attention. CONCLUSION: Abnormal MCA Doppler is a predictor of neurobehavioral disruption among preterm newborns with IUGR, which suggests that this sign reflects an advanced stage of brain injury with a higher risk of abnormal neurological maturation. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
Francesc Figueras; Rogelio Cruz-Martinez; Magdlena Sanz-Cortes; Angela Arranz; Miriam Illa; Francesc Botet; Carme Costas-Moragas; Eduard Gratacos
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-6
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Maternal-Fetal Medicine Department. Hospital Clínic. Universitat de Barcelona. Barcelona, Spain; Perinatal Research Group. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS). Barcelona, Spain. ffiguera@clinic.ub.es.
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