Neurodevelopmental outcome in very low birthweight infants with pathological umbilical artery flow

Simonne Brütsch, Tilo Burkhardt, Juozas Kurmanavicius, Dirk Bassler, Roland Zimmermann, Giancarlo Natalucci, Nicole Ochsenbein-Kölble
Archives of Disease in Childhood. Fetal and Neonatal Edition 2016, 101 (3): F212-6

OBJECTIVE: To assess neurodevelopmental outcome during toddlerhood in very low birthweight (VLBW) infants with absent or reverse end-diastolic flow (AREDF) in the umbilical artery (UA) during pregnancy.

DESIGN: Retrospective cohort study with matched control group.

SETTING: Tertiary perinatal centre.

PATIENTS AND OUTCOME MEASURES: We compared longitudinally collected data on neonatal and neurodevelopmental outcomes among 41 infants born in our institution from 1997 to 2010 with birth weight <1500 g and UA AREDF and 41 infants with prenatally normal UA Doppler parameters matched for gestational age, birth weight, sex and year of birth. We evaluated neurodevelopmental outcome at a median (range) corrected age of 23.3 (10.1-29.6) months using the Bayley scales of infant development, 2nd edition (BSID-II), and neurological examination.

RESULTS: The mental development index in UA AREDF children (median (range) 84 (49-116)) was significantly lower than in controls (median (range) 91 (62-140)), including after adjustment for confounders. Intergroup differences in psychomotor development index (PDI; BSID-II) and the rate of cerebral palsy or minor neuromotor dysfunction were non-significant.

CONCLUSIONS: VLBW infants with UA AREDF have a higher risk of poorer mental development during toddlerhood than controls matched for gestational age, birth weight, sex and year of birth. UA AREDF may be considered a prenatal predictor of poorer mental development in this population. Long-term follow-up studies with larger cohorts are needed to better evaluate the impact of this prenatal factor on later neurodevelopment.


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