Two-year neurological outcome of very-low-birth-weight children with prenatal absent or reversed end-diastolic flow velocity in the umbilical artery.
OBJECTIVE
The aim of this study was to investigate the 2-year neurological outcome of very-low-birth-weight (VLBW) children who had abnormal umbilical blood flow velocity prenatally.


METHODS
We performed a prospective collection of infants prenatally diagnosed with abnormal umbilical blood flow velocity at a tertiary referral center from January 1, 2001 to September 30, 2005. VLBW children with prenatal absent or reversed end-diastolic flow velocity (AREDV) in the umbilical artery were investigated and compared with two similar demographic control groups of VLBW children without AREDV: one group with fetal growth restriction and the other without it. A follow-up study at 2 years of age for Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) of the Bayley Scales among the three groups was analyzed.


RESULTS
Twenty-four VLBW children were identified to have AREDV prenatally, of whom four died during the neonatal period. After 2 years, five children were lost to follow-up and 15 were rescued, of whom 11 had absent end-diastolic velocity and four reversed end-diastolic velocity. We compared the remaining 15 children with the two control groups [28 children in the matched control group with intrauterine fetal growth restriction (IUGR), and 38 children in the matched control group without IUGR], and no significant differences were found in MDI (p = 0.938) and PDI (p = 0.496) scores at 2 years of age. However, we also surveyed the children with a gestational age of ≤ 29 weeks and found a significant difference in MDI scores (p = 0.048), but not in PDI scores (p = 0.219), among the three groups.


CONCLUSIONS
VLBW children delivered earlier than 29 gestational weeks with abnormal umbilical blood flow velocity prenatally have greater mental developmental delay at 2 years of age.
Division of High Risk Pregnancy, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Institute of Biomedical Engineering and College of Medicine, National Taiwan University, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
Chen-Yu
CY
Chen
Kuo-Gon
KG
Wang
Shwu-Meei
SM
Wang
Chie-Pein
CP
Chen
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003971:Diastole / Q000502:physiology; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D005333:Fetus / Q000098:blood supply / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*
Mental Developmental Index; Psychomotor Developmental Index; absent or reversed end-diastolic velocity; intrauterine growth restriction; very low birth weight