Cerebral blood perfusion and neurobehavioral performance in full-term small-for-gestational-age fetuses.
OBJECTIVE
The purpose of this study was to evaluate changes in cerebral blood perfusion and middle cerebral artery (MCA) Doppler in full-term small-for-gestational-age fetuses (SGA) and to explore their association with neonatal neurobehavioral performance.


METHODS
Frontal brain perfusion that was measured by fractional moving blood volume (FMBV) and MCA Doppler pulsatility index were assessed in 60 SGA fetuses with normal umbilical artery Doppler results that were matched with adequate-for-gestational-age fetuses. Neonates were evaluated with the Neonatal-Behavioral-Assessment-Scale (NBAS).


RESULTS
The proportion of SGA fetuses with increased FMBV (35% vs 5%; P < .001) and decreased MCA Doppler pulsatility index (15% vs 1.7%; P < .01) was significantly higher. SGA fetuses showed poorer NBAS scores in all areas. Increased FMBV identified SGA fetuses with the highest risks of abnormal NBAS in social-interactive (odds ratio, 7.8), attention (odds ratio, 22.8), and state-organization (odds ratio, 25.0). Abnormal MCA Doppler identified SGA with abnormal scores in motor area (odds ratio, 10.7).


CONCLUSIONS
Increased brain blood perfusion discriminates SGA fetuses that are at risk for abnormal neurobehavior.
Cruz-Martinez
Rogelio
R
Department of Maternal-Fetal Medicine, Hospital Clinic-University of Barcelona, Barcelona, Spain.
Figueras
Francesc
F
Oros
Daniel
D
Padilla
Nelly
N
Meler
Eva
E
Hernandez-Andrade
Edgar
E
Gratacos
Eduard
E
D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D047929:Term Birth; D018608:Ultrasonography, Doppler