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Am J Obstet Gynecol. 2009 Nov;201(5):474.e1-7. doi: 10.1016/j.ajog.2009.05.028. Epub 2009 Jul 24.

Cerebral blood perfusion and neurobehavioral performance in full-term small-for-gestational-age fetuses.

Author information

1
Department of Maternal-Fetal Medicine, Hospital Clinic-University of Barcelona, Barcelona, Spain.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate changes in cerebral blood perfusion and middle cerebral artery (MCA) Doppler in full-term small-for-gestational-age fetuses (SGA) and to explore their association with neonatal neurobehavioral performance.

STUDY DESIGN:

Frontal brain perfusion that was measured by fractional moving blood volume (FMBV) and MCA Doppler pulsatility index were assessed in 60 SGA fetuses with normal umbilical artery Doppler results that were matched with adequate-for-gestational-age fetuses. Neonates were evaluated with the Neonatal-Behavioral-Assessment-Scale (NBAS).

RESULTS:

The proportion of SGA fetuses with increased FMBV (35% vs 5%; P < .001) and decreased MCA Doppler pulsatility index (15% vs 1.7%; P < .01) was significantly higher. SGA fetuses showed poorer NBAS scores in all areas. Increased FMBV identified SGA fetuses with the highest risks of abnormal NBAS in social-interactive (odds ratio, 7.8), attention (odds ratio, 22.8), and state-organization (odds ratio, 25.0). Abnormal MCA Doppler identified SGA with abnormal scores in motor area (odds ratio, 10.7).

CONCLUSION:

Increased brain blood perfusion discriminates SGA fetuses that are at risk for abnormal neurobehavior.

PMID:
19631930
DOI:
10.1016/j.ajog.2009.05.028
[Indexed for MEDLINE]

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