Document Detail


Predictors of outcome at 2 years of age after early intrauterine growth restriction.
MedLine Citation:
PMID:  20217892     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the relative importance of antenatal and perinatal variables on short- and long-term outcome of preterm growth restricted fetuses with umbilical artery (UA) Doppler abnormalities.
METHODS: This was a cohort study of 180 neonates with birth weight < 10(th) percentile, gestational age at delivery < 34 weeks and abnormal Doppler ultrasound examination of the UA. Various antenatal and perinatal variables were studied in relation to short- and long-term outcome.
RESULTS: Neonatal and overall mortality (up to 2 years of age) were predicted by low gestational age at delivery. Neonatal mortality was additionally predicted by absent or reversed UA end-diastolic flow, while the presence of severe neonatal complications and placental villitis were additional predictors of both infant (between 28 days and 1 year of postnatal life) and overall mortality. Placental villitis was found to be the only predictor of necrotizing enterocolitis. Low gestational age at delivery, male sex, abnormal cardiotocography, absent or reversed UA end-diastolic flow and the HELLP syndrome predicted respiratory distress syndrome. Abnormal neurodevelopmental outcome at 2 years was predicted by low birth weight (< 2.3(rd) percentile), fetal acidosis (UA pH < 7.00), and placental villitis.
CONCLUSION: Less advanced gestation at delivery remains an important predictor of short-term outcome in growth-restricted fetuses. In addition, the presence of placental villitis may aid neonatologists in the early identification of infants at increased risk of necrotizing enterocolitis, death and abnormal neurodevelopment at 2 years of age. Abnormal neurodevelopment was related to low weight and acidosis at birth, indicating that the severity of malnutrition and fetal acidosis affect long-term outcome.
Authors:
H L Torrance; M C T Bloemen; E J H Mulder; P G J Nikkels; J B Derks; L S de Vries; G H A Visser
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:  36     ISSN:  1469-0705     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-03     Completed Date:  2011-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  171-7     Citation Subset:  IM    
Affiliation:
Perinatal Center, Wilhelmina Children's Hospital, Utrecht, The Netherlands. H.Torrance@umcutrecht.nl
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MeSH Terms
Descriptor/Qualifier:
Acidosis / diagnosis,  embryology,  physiopathology*
Adolescent
Adult
Blood Flow Velocity / physiology
Child Development*
Child, Preschool
Female
Fetal Growth Retardation / diagnosis,  mortality,  physiopathology*
Gestational Age
Humans
Infant Mortality
Infant, Low Birth Weight
Infant, Newborn
Male
Placenta Diseases / diagnosis,  mortality,  physiopathology*
Predictive Value of Tests
Pregnancy
Ultrasonography, Prenatal
Umbilical Arteries / embryology,  physiopathology*,  ultrasonography
Young Adult

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


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