DOI:10.18643/gieu.2013.35
"> DOI:10.18643/gieu.2013.35
"> DOI:10.18643/gieu.2013.35
"/> Intrauterine growth restriction: perinatal assessment in predicting the offspring neurologic impairment. A 2 years prospective study
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GINECOeu9(1)35-40(2013)
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Intrauterine growth restriction: perinatal assessment in predicting the offspring neurologic impairment. A 2 years prospective study

S. Constantinescu, M. Deneș, R. Vlădăreanu


Abstract: We aimed to assess the correlation between some perinatal parameters in intrauterine growth restriction (IUGR) pregnancy and postnatal neurological impairment in the offspring. Those parameters were studied as predicting factors for the offspring’s neurological outcomes at the age of 2. This was a prospective observational study including 81 pregnancies complicated by intrauterine growth restriction. By the perinatal surveillance parameters we studied the umbilical artery (UA),ductus venosus (DV) and middle cerebral artery, Doppler features, biophysical profile (BPP) score, antenatal Kanet neurologic score, Apgar score, birth acidemia, gestational age and birth weight. The neonates were monitored during the next 2 years from the point of view of neurological outcomes such as: motor anomalies, abnormal speech, abnormal hearing and vision, neurosensory abnormalities, cerebral palsy, global neurodevelopment delay. At the end of those two years we made the connections between the perinatal assessments and postnatal findings, describing the relationship of the perinatal parameters’ disturbances with the specific postnatal neurologic outcomes. Results. Seventeen pregnancies (25%) had absent or reversed end-diastolic velocities (A/R-EDV) on UA, 25 (36.76%) abnormal DV Doppler features, 20 (29.41%) abnormal BPP, 21 (30.88%) and 6 (8.82%) had abnormal, respectively borderline Kanet scores. The gestational age was in the range 32-38 weeks and the birth weight between 1530-1730 g. After 2 years of follow up we found 14 (20.58%) cases of motor abnormalities, 6 (8.82%) cases of abnormal hearing, 17 children (25%) with speech abnormalities, 8 (11.76%) cases of neurosensory abnormalities and 12 (17.64%) cases of global neurodevelopment delay. There were no cases of visual abnormalities and only one case of cerebral palsy. Conclusions. In IUGR pregnancies the most important independent predictor factor for poor neurodevelopment remains UA R-EDV, even though DV abnormalities, BPP abnormal score as well as gestational age and birth weight play an important role in most of the offspring’s neurologic impairments.
DOI:10.18643/gieu.2013.35

Keywords: intrauterine growth restriction, Doppler, neurodevelopment

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