title: Suboptimal neurodevelopment in very preterm infants is related to fetal cardiovascular compromise in placental insufficiency.
abstract: OBJECTIVE
  The purpose of this study was to determine the relationship between fetal cardiovascular hemodynamics and neurodevelopmental outcome in infants born before 32 gestational weeks with placental insufficiency.
  
  
  METHODS
  Seventeen fetuses that underwent Doppler ultrasonography within 24 hours before delivery were included in this prospective cross-sectional study. Placental histology was examined. Multiple inflammatory markers and vascular endothelial growth factor (VEGF) and its receptor were analyzed from umbilical cord serum. Neurodevelopmental outcome was assessed by Griffiths scales at 1 year of corrected age.
  
  
  RESULTS
  Infants with suboptimal outcome (n = 7) had higher umbilical artery, ductus venosus, and inferior vena cava pulsatility index values (P < .05) and lower weight-indexed cardiac outputs (P < .05) than infants with normal outcome (n = 10). Placental histology and serum revealed no inflammation. VEGF values were similar among all infants.
  
  
  CONCLUSIONS
  In placental insufficiency with delivery before 32 gestational weeks, suboptimal neurodevelopment was related to decreased fetal weight-indexed cardiac output and increased systemic venous pressure.
authors.affiliation: Department of Pediatrics, University of Oulu, Oulu, Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Kaukola
authors.forename: Juha
authors.initials: J
authors.lastname: Räsänen
authors.forename: Riitta
authors.initials: R
authors.lastname: Herva
authors.forename: Dhavalkumar D
authors.initials: DD
authors.lastname: Patel
authors.forename: Mikko
authors.initials: M
authors.lastname: Hallman
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D005318:Fetal Heart / Q000503:physiopathology*; D005333:Fetus / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D009420:Nervous System / Q000254:growth & development*; D010927:Placental Insufficiency / Q000150:complications* / Q000503:physiopathology*; D011247:Pregnancy; D011446:Prospective Studies; D011673:Pulsatile Flow; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000502:physiology; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000097:blood
chemical_list: D042461:Vascular Endothelial Growth Factor A; D018799:Intercellular Adhesion Molecule-1; D040301:Vascular Endothelial Growth Factor Receptor-2