Neurobehavioral outcomes in preterm, growth-restricted infants with and without prenatal advanced signs of brain-sparing
Article first published online: 10 AUG 2011
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 38, Issue 3, pages 288–294, September 2011
How to Cite
Figueras, F., Cruz-Martinez, R., Sanz-Cortes, M., Arranz, A., Illa, M., Botet, F., Costas-Moragas, C. and Gratacos, E. (2011), Neurobehavioral outcomes in preterm, growth-restricted infants with and without prenatal advanced signs of brain-sparing. Ultrasound Obstet Gynecol, 38: 288–294. doi: 10.1002/uog.9041
- Issue published online: 29 AUG 2011
- Article first published online: 10 AUG 2011
- Accepted manuscript online: 6 MAY 2011 05:30AM EST
- Manuscript Accepted: 29 APR 2011
- Marie Curie grant from the EC
- intrauterine growth restriction;
- middle cerebral artery;
- neurobehavioral outcome
To evaluate the neurobehavioral outcomes of preterm infants with intrauterine growth restriction (IUGR), with and without prenatal advanced brain-sparing.
A cohort of IUGR infants (birth weight < 10th percentile with abnormal umbilical artery Doppler) born before 34 weeks of gestation was compared with a control group of appropriate-for-gestational age infants matched for gestational age at delivery. MCA pulsatility index was determined in all cases within 72 hours before delivery. Neonatal neurobehavior was evaluated at 40 weeks' ( ± 1) corrected age using the Neonatal Behavioral Assessment Scale. The effect of abnormal MCA pulsatility index (< 5th percentile) on each neurobehavioral area was adjusted for maternal smoking status and socioeconomic level, mode of delivery, gestational age at delivery, pre-eclampsia, newborn illness severity score and infant sex by multiple linear and logistic regression.
A total of 126 preterm newborns (64 controls and 62 IUGR) were included. Among IUGR fetuses, the proportion of abnormal MCA Doppler parameters was 53%. Compared with 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 system, social-interactive and attention. Similarly, the proportion of infants with abnormal neurobehavioral scores was significantly higher in the IUGR subgroup with abnormal MCA Doppler parameters in the areas of habituation, social-interactive, motor system and attention.
Abnormal MCA Doppler findings are predictive of neurobehavioral impairment among preterm newborns with IUGR, which suggests that this reflects an advanced stage of brain injury with a higher risk of abnormal neurological maturation. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.