Antenatal tests of fetal welfare and development at age 2 years.
OBJECTIVE
Our objective was to examine the outcomes at 2 years of age of fetuses delivered electively before 34 weeks, studied antenatally with two tests of fetal well-being.


METHODS
Forty-two fetuses from high-risk pregnancies delivered electively by cesarean section before 34 weeks were stratified into normal versus abnormal subgroups with umbilical Doppler flow velocity waveform and fetal heart rate results. Developmental outcome was assessed at 2 years. Two comparison groups were also selected: 40 matched premature controls delivered spontaneously before 34 weeks and 67 normal babies delivered spontaneously at term. Frequency outcome data were tested with chi 2 analyses and the remainder with analyses of variance.


RESULTS
Within the electively delivered study group poor cognitive progress at 2 years was more strongly associated with an abnormal fetal heart rate result than an abnormal Doppler result. Compared with the premature control and normal term groups, electively delivered fetuses were significantly delayed in growth, cognition, and motor development (p < 0.005).


CONCLUSIONS
Adverse fetal welfare in a high-risk obstetric sample was associated with poorer outcome at 2 years. However, the whole of the group of fetuses from such high-risk pregnancies showed significant developmental delay compared with normal term children and, more importantly, matched premature infants delivered spontaneously from otherwise uncomplicated pregnancies.
Todd
A L
AL
Department of Obstetrics and Gynaecology, University of Sydney, Westmead Hospital, New South Wales, Australia.
Trudinger
B J
BJ
Cole
M J
MJ
Cooney
G H
GH
D002585:Cesarean Section; D002657:Child Development; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D005323:Fetal Monitoring; D006128:Growth; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009048:Motor Skills; D011247:Pregnancy; D011248:Pregnancy Complications