Antenatal Doppler measurements and early brain injury in very low birth weight infants.
OBJECTIVE
To determine the correlation between fetoplacental blood flow and brain injury and volumes in very low birth weight (VLBW) infants.


METHODS
Antenatal blood flow from the umbilical artery (UA), middle cerebral artery (MCA), and descending aorta was determined in 70 VLBW infants. The directions of the total diastolic flow of the aortic isthmus and the end-diastolic flow of ductus venosus also were measured. Serial brain ultrasound examinations and MRI at term were performed to assess brain abnormalities. On the basis of brain imaging findings, the newborn infants were classified as normal (n = 14), intermediate brain pathology (n = 31), and major pathology (n = 25) groups.


RESULTS
Abnormalities in fetoplacental blood flow were not related to anatomic brain lesions. However, an abnormal UA/MCA pulsatility index ratio was associated with reduced total brain volume (mean, 360 mL; SD, 32.5 mL) and reduced cerebral volume (344 mL; SD, 28.4 mL) compared with infants with normal UA/MCA pulsatility index ratio (mean, 405 mL; SD, 51.3 mL, P = .01, and mean, 368 mL; SD, 52.3 mL, P = .012), respectively.


CONCLUSIONS
Redistribution of fetal blood flow in VLBW infants is associated with reduced brain volume at term age. Neurodevelopmental follow-up of this cohort will clarify the significance of these blood flow changes on development.
Maunu
Jonna
J
Department of Pediatric Neurology, University of Turku and Turku University Hospital, Turku, Finland. jonna.maunu@utu.fi <jonna.maunu@utu.fi>
Ekholm
Eeva
E
Parkkola
Riitta
R
Palo
Pertti
P
Rikalainen
Hellevi
H
Lapinleimu
Helena
H
Haataja
Leena
L
Lehtonen
Liisa
L
D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001783:Blood Flow Velocity / Q000502:physiology; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008279:Magnetic Resonance Imaging; D008297:Male; D007744:Obstetric Labor Complications; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D018608:Ultrasonography, Doppler; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*