title: Neurodevelopmental outcome in very low birthweight infants with pathological umbilical artery flow.
abstract: OBJECTIVE
  To assess neurodevelopmental outcome during toddlerhood in very low birthweight (VLBW) infants with absent or reverse end-diastolic flow (AREDF) in the umbilical artery (UA) during pregnancy.
  
  
  METHODS
  Retrospective cohort study with matched control group.
  
  
  METHODS
  Tertiary perinatal centre.
  
  
  METHODS
  We compared longitudinally collected data on neonatal and neurodevelopmental outcomes among 41 infants born in our institution from 1997 to 2010 with birth weight <1500 g and UA AREDF and 41 infants with prenatally normal UA Doppler parameters matched for gestational age, birth weight, sex and year of birth. We evaluated neurodevelopmental outcome at a median (range) corrected age of 23.3 (10.1-29.6) months using the Bayley scales of infant development, 2nd edition (BSID-II), and neurological examination.
  
  
  RESULTS
  The mental development index in UA AREDF children (median (range) 84 (49-116)) was significantly lower than in controls (median (range) 91 (62-140)), including after adjustment for confounders. Intergroup differences in psychomotor development index (PDI; BSID-II) and the rate of cerebral palsy or minor neuromotor dysfunction were non-significant.
  
  
  CONCLUSIONS
  VLBW infants with UA AREDF have a higher risk of poorer mental development during toddlerhood than controls matched for gestational age, birth weight, sex and year of birth. UA AREDF may be considered a prenatal predictor of poorer mental development in this population. Long-term follow-up studies with larger cohorts are needed to better evaluate the impact of this prenatal factor on later neurodevelopment.
authors: Obstetric Research Unit, Clinic of Obstetrics, Zurich University Hospital, Zurich, Switzerland.
authors: Simonne
authors: S
authors: Brütsch
authors: Obstetric Research Unit, Clinic of Obstetrics, Zurich University Hospital, Zurich, Switzerland.
authors: Tilo
authors: T
authors: Burkhardt
authors: Obstetric Research Unit, Clinic of Obstetrics, Zurich University Hospital, Zurich, Switzerland.
authors: Juozas
authors: J
authors: Kurmanavicius
authors: Division of Neonatology, Zurich University Hospital, Zurich, Switzerland.
authors: Dirk
authors: D
authors: Bassler
authors: Obstetric Research Unit, Clinic of Obstetrics, Zurich University Hospital, Zurich, Switzerland.
authors: Roland
authors: R
authors: Zimmermann
authors: Division of Neonatology, Zurich University Hospital, Zurich, Switzerland Child Development Centre, Children's University Hospital Zurich, Zurich, Switzerland.
authors: Giancarlo
authors: G
authors: Natalucci
authors: Obstetric Research Unit, Clinic of Obstetrics, Zurich University Hospital, Zurich, Switzerland.
authors: Nicole
authors: N
authors: Ochsenbein-Kölble
mesh_terms: D016022:Case-Control Studies; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight / Q000254:growth & development*; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D018617:Ultrasonography, Doppler, Pulsed; D014469:Umbilical Arteries / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology*
keywords: Neurodevelopment; Prematurity; Umbilical cord; absent/reverse end-diastolic flow; very-low-birth-weight