Predictors of outcome at 2 years of age after early intrauterine growth restriction
| Autor: | Peter G. J. Nikkels, L S de Vries, E. J. H. Mulder, J. B. Derks, Gerard H. A. Visser, M. C. T. Bloemen, H. L. Torrance |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Placenta Diseases Adolescent Birth weight Intrauterine growth restriction Gestational Age Placental insufficiency Ultrasonography Prenatal Umbilical Arteries Young Adult Child Development Predictive Value of Tests Pregnancy Infant Mortality medicine Humans Radiology Nuclear Medicine and imaging Fetal Growth Retardation Radiological and Ultrasound Technology business.industry Obstetrics Infant Newborn Obstetrics and Gynecology Gestational age General Medicine Infant Low Birth Weight medicine.disease Low birth weight Reproductive Medicine Child Preschool Necrotizing enterocolitis Female medicine.symptom Acidosis business Villitis of unknown etiology Blood Flow Velocity |
| Zdroj: | Ultrasound in Obstetrics and Gynecology. 36:171-177 |
| ISSN: | 0960-7692 |
| DOI: | 10.1002/uog.7627 |
| Popis: | Objective To examine the relative importance of antenatal and perinatal variables on short- and long-term outcome of preterm growth restricted fetuses with umbilical artery (UA) Doppler abnormalities. Methods This was a cohort study of 180 neonates with birth weight < 10th percentile, gestational age at delivery < 34 weeks and abnormal Doppler ultrasound examination of the UA. Various antenatal and perinatal variables were studied in relation to short- and long-term outcome. Results Neonatal and overall mortality (up to 2 years of age) were predicted by low gestational age at delivery. Neonatal mortality was additionally predicted by absent or reversed UA end-diastolic flow, while the presence of severe neonatal complications and placental villitis were additional predictors of both infant (between 28 days and 1 year of postnatal life) and overall mortality. Placental villitis was found to be the only predictor of necrotizing enterocolitis. Low gestational age at delivery, male sex, abnormal cardiotocography, absent or reversed UA end-diastolic flow and the HELLP syndrome predicted respiratory distress syndrome. Abnormal neurodevelopmental outcome at 2 years was predicted by low birth weight (< 2.3rd percentile), fetal acidosis (UA pH < 7.00), and placental villitis. Conclusion Less advanced gestation at delivery remains an important predictor of short-term outcome in growth-restricted fetuses. In addition, the presence of placental villitis may aid neonatologists in the early identification of infants at increased risk of necrotizing enterocolitis, death and abnormal neurodevelopment at 2 years of age. Abnormal neurodevelopment was related to low weight and acidosis at birth, indicating that the severity of malnutrition and fetal acidosis affect long-term outcome. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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