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Ultrasound Obstet Gynecol. 2008 Dec;32(7):894-9. doi: 10.1002/uog.6249.

Neurodevelopmental outcome in 2-year-old infants who were small-for-gestational age term fetuses with cerebral blood flow redistribution.

Author information

1
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.

Abstract

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.

PMID:
19035538
DOI:
10.1002/uog.6249
[Indexed for MEDLINE]
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