Absent or reverse end-diastolic flow in the umbilical artery: intellectual development at school age.
OBJECTIVE
This study was designed to establish whether, in growth-retarded fetuses, absent or reverse end-diastolic (ARED) flow velocity in the umbilical artery can be predictive of an increased incidence of long-term neurological and intellectual impairment.


METHODS
A total of 14 children with intra-uterine growth retardation (IUGR) and ARED flow in the umbilical artery and 11 children without this velocimetric pattern were examined by pediatric neuropsychiatrists at a median age of 8.7 years to evaluate and compare their neurological and intellectual development.


RESULTS
The incidence of major neurological sequelae was higher in the children with ARED velocity in the umbilical artery (21%) than in those without this velocimetric pattern (9%), as was the incidence of mild neurological sequelae (35% versus 27%). No differences in mean intelligence quotient (IQ) as evaluated by mean of Intelligence Scale for Children-Revised (WISC-R) scale were found between the two groups of children at school age.


CONCLUSIONS
Our data demonstrate that Doppler velocimetry in the umbilical artery is a reliable predictor for neurological sequelae when ARED flow is present but cannot be considered a good predictor of intellectual performance at school.
Valcamonico
Adriana
A
Department of Obstetrics and Gynecology, University of Brescia, Italy. lufa1963@numerica.it
Accorsi
Patrizia
P
Battaglia
Silvia
S
Soregaroli
Mirella
M
Beretta
Daniela
D
Frusca
Tiziana
T
D000328:Adult; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D003971:Diastole; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D015994:Incidence; D007361:Intelligence Tests; D007558:Italy / Q000453:epidemiology; D011247:Pregnancy; D011673:Pulsatile Flow; D014469:Umbilical Arteries / Q000502:physiology*