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Foetal umbilical artery Doppler in small preterms: (IQ) Neurocognitive outcome at 5 years of age

Authors

  • Siw Helen W. Eger,

    Corresponding author
    1. Department of Clinical Medicine, University of Bergen, Bergen, Norway
    2. Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
    • Correspondence

      Siw Helen W. Eger, M.D., Department of Pediatrics, N-5021 Haukeland University Hospital, Norway. Tel: + 47 930 28 704 | Fax: +47 559 75 147 | Email: helen@westbyeger.no

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  • Kristian Sommerfelt,

    1. Department of Clinical Medicine, University of Bergen, Bergen, Norway
    2. Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
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  • Torvid Kiserud,

    1. Department of Clinical Medicine, University of Bergen, Bergen, Norway
    2. Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
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  • Trond Markestad

    1. Department of Clinical Medicine, University of Bergen, Bergen, Norway
    2. Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
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Abstract

Aim

To investigate whether absent or reversed end-diastolic flow in the umbilical artery (AREDF) is associated with neonatal mortality, morbidity or long-term neurocognitive outcome in extremely preterm infants exposed to preeclampsia or intrauterine growth restriction.

Methods

Prenatal Doppler data were retrospectively collected for liveborn infants with gestational age (GA) <28 weeks or birth weight (BW) <1000 g, born small for gestational age (SGA- BW <5th percentile for GA) or of mothers with preeclampsia at the four largest university hospitals in Norway during 1999–2000. Neonatal mortality and morbidities, cerebral palsy (CP) and IQ at 5 years of age were compared for infants with or without AREDF.

Results

Of 260 infants, 84 were eligible and 71 of them had sufficient Doppler data. Of these, 38 (54%) had AREDF. Of 33 infants born <28 weeks, 7 of 19 (37%) with AREDF and none of 14 without AREDF had severe cerebral haemorrhage (SCH) (p = 0.01). AREDF was not significantly associated with mortality, other NICU morbidities, CP or reduced IQ. For the 38 infants with GA ≥28 weeks, AREDF (19 of 38) was not associated with adverse outcomes.

Conclusion

Absent or reversed end-diastolic flow in the umbilical artery (AREDF) was associated with increased risk of SCH in extremely preterm infants (GA <28 weeks).

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