engleski

Early neurological outcome of neonates with intrauterine growth restriction

Intrauterine growth restriction (IUGR) is considered a risk factor for neurodevelopmental disorders having an unfavorable long-term outcome. The aim of the study was to evaluate the relationship between fetal Doppler parameters, umbilical cord blood gas values and early neurological outcome in growth-restricted infants.Prospective study included 60 singleton pregnancies complicated by IUGR defined as an estimated fetal weight below 10th percentile (calculated on the basis of ultrasound fetal biometry). The relationship between the umbilical artery (UA) and the middle cerebral artery (MCA) resistance indices (RI), umbilical arterial and venous pH, pO2 and pCO2 and early neurological outcome evaluated with the Amiel-Tison Neurological Assesment at Term (ATNAT) were analysed. Multivariant t-test (Hoteling´s T2 test ) was used in statistical analysis. P< 0, 05 was considered statistically significant.RESULTS: of the 60 growth-restricted infants, 19 had optimal and 41 had non-optimal neurological status (minor or moderate degree of neurological abnormalities, none severe). Neonates with non-optimal neurological status had signifficantly lower birth weight compared to those with normal neurological status (mean±SD: 2168, 5g±309, 9 versus 2485, 2g ±202, 3 ). A significant association between pathological arterial Doppler (incerased UA-RI), low umbilical cord blood oxygen and early neurological abnormalities were found.There were no significant differences in MCA-RI, umbilical arterial and venous pH and pCO2 between these two IUGR groups.The present study showed that increased UA-RI and low umbilical cord pO2 are significanlty predictive for early neurological abnormalities among neonates with IUGR in addition to birth weight and can be used in risk assesment.

IUGR; fetal Doppler parameters; early neurological outcome

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