Document Detail


Neurodevelopmental outcome in 2-year-old infants who were small-for-gestational age term fetuses with cerebral blood flow redistribution.
MedLine Citation:
PMID:  19035538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the neurodevelopmental outcome at 2 years of age of children who had been small-for-gestational-age (SGA) term babies with cerebral blood flow redistribution. METHODS: Perinatal outcome was assessed in a cohort of 97 term singleton appropriate-for-gestational-age and 125 term singleton SGA fetuses with normal umbilical artery Doppler, stratified according to the presence of cerebral blood flow redistribution. Neurodevelopmental outcome was assessed prospectively at 2 years of age by means of the 24-month Age & Stage Questionnaire (ASQ). RESULTS: Of the 125 SGA fetuses, 25 had redistribution of the cerebral blood flow, and 100 did not. There were no significant differences in perinatal outcome between these two SGA groups. At 2 years of age, children who had been SGA fetuses with middle cerebral artery (MCA) pulsatility index (PI) < 5(th) centile had a higher incidence of suboptimal neurodevelopmental outcome compared with those with normal MCA-PI (52% vs. 31%; P = 0.049) and a lower mean centile in communication (53.1 vs. 67.4; P = 0.006) and problem-solving (39.7 vs. 47.4; P = 0.04) areas. CONCLUSION: SGA fetuses with cerebral blood flow redistribution have a higher risk of subtle neurodevelopmental deficits at 2 years of age. This challenges the concept that fetal cerebral redistribution is an entirely protective mechanism and suggests MCA-PI as a risk stratifying factor for adverse neurodevelopmental outcome.
Authors:
E Eixarch; E Meler; A Iraola; M Illa; F Crispi; E Hernandez-Andrade; E Gratacos; F Figueras
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  32     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-02     Completed Date:  2009-08-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  894-9     Citation Subset:  IM    
Copyright Information:
(c) 2008 ISUOG.
Affiliation:
Maternal-Fetal Medicine Department, ICGON, Fetal and Perinatal Research Group, IDIBAPS, Hospital Clinic, University of Barcelona, Centre for Biomedical Research on Rare Diseases (CIBERER), Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Cerebrovascular Circulation*
Child Development*
Child, Preschool
Cohort Studies
Communication
Developmental Disabilities / diagnosis,  etiology*
Female
Humans
Infant, Newborn
Infant, Small for Gestational Age / growth & development,  physiology*
Motor Skills
Pregnancy
Problem Solving
Prospective Studies
Pulsatile Flow / physiology
Questionnaires
Social Behavior
Ultrasonography, Doppler / instrumentation
Ultrasonography, Prenatal / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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