Postnatal neuro-development of fetuses with absent end-diastolic flow in the umbilical artery and/or fetal descending aorta.
OBJECTIVE
To determine whether absence of end-diastolic flow in the umbilical artery and/or fetal aorta impacts postnatal neuro-development in preterm-born children.


METHODS
The study group, consisting of 43 fetuses with absent end-diastolic flow in the umbilical artery and/or fetal aorta, was compared with a control group, consisting of 30 fetuses, matching for gestational age but with normal doppler-flow results. The children's neuro-developmental status was assessed using the 'Munich functional developmental diagnostics' (MFDD), between the 2nd and 3rd year of life.


RESULTS
Gestational age at birth was 33 + 6 weeks in the study group and 34 + 4 weeks in the control group. A brain-sparing effect was observed in 37.3% of fetuses in the study group compared with 10.0% in the control group (p = 0.014). For all seven MFDD domains, the number of children with deficiencies was higher in the study group. For the domains perception, active speech and comprehension this effect was statistically significant (p < 0.05). Overall, 30.2% of children in the study group and 16.7% of the control group had pathologic test results (p < 0.013).


CONCLUSIONS
Pathological doppler-flow in the umbilical artery and/or fetal descending aorta in preterm born children is associated with neuro-developmental deficiencies. Intensive pediatric care is recommended to mitigate these deficiencies during early childhood.
Department of Obstetrics and Gynecology, Hospital of Leverkusen, Teaching Hospital of University of Cologne, 51375 Leverkusen, Germany. ertan@klinikum-lev.de
A Kubilay
AK
Ertan
H Alper
HA
Tanriverdi
Alexander
A
Stamm
Wolfgang
W
Jost
Jan
J
Endrikat
Werner
W
Schmidt
D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001921:Brain / Q000098:blood supply / Q000254:growth & development; D002675:Child, Preschool; D005260:Female; D005333:Fetus / Q000098:blood supply / Q000294:innervation; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D012737:Sex Factors; D013064:Speech Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D018608:Ultrasonography, Doppler / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*