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Abnormal fetal aortic velocity waveform and postnatal growth
1Department of Paediatrics, Lund University Hospital, Sweden. david.ley@skane.se
Insights
Children with abnormal fetal blood flow showed initial catch-up growth but long-term outcomes were not significantly different from peers. Birth size deficit was a stronger predictor of postnatal growth than fetal blood flow patterns.
Area of Science:
- Pediatrics
- Fetal Medicine
- Growth and Development
Background:
- Intrauterine growth retardation (IUGR) affects postnatal development.
- Fetal Doppler velocimetry assesses fetal well-being and predicts outcomes.
- Understanding long-term growth trajectories in IUGR is crucial.
Purpose of the Study:
- To evaluate postnatal growth up to 7 years in children with varying degrees of IUGR.
- To determine the relationship between abnormal fetal aortic blood flow and postnatal growth patterns.
- To identify predictors of subsequent growth in IUGR infants.
Main Methods:
- Longitudinal study of 151 children with IUGR.
- Previous intrauterine assessment using Doppler velocimetry of the thoracic descending aorta.
- Postnatal growth evaluation (weight, length/height) from birth to 7 years.
Main Results:
- Infants with abnormal fetal aortic blood flow (BFC) showed initial catch-up growth in weight and length.
- Postnatal growth patterns did not significantly differ between abnormal and normal BFC groups up to 7 years.
- Abnormal fetal aortic waveform was not related to early catch-up growth or 7-year growth after adjusting for birth size.
- Magnitude of birth weight and length deficit was more predictive of subsequent growth.
Conclusions:
- Abnormal fetal aortic blood flow patterns do not appear to significantly impact long-term postnatal growth trajectories in IUGR children.
- Birth size deficit is a more significant predictor of growth outcomes than fetal aortic blood flow abnormalities.
- Early catch-up growth does not fully compensate for initial growth deficits in IUGR.
Abstract:
Postnatal growth from birth up to 7 y of age was evaluated in 151 children with varying degrees of intrauterine growth retardation who were previously examined in their intrauterine life with Doppler velocimetry of the thoracic descending aorta. The children with abnormal fetal aortic blood flow class (BFC), of which 39/46 (85%) had a birthweight > or = 2 SD below the mean of the population, were lean at birth and had a high rate of catch-up growth in weight and length during the first 3 and 6 mo, respectively. After the initial phases of rapid catch-up in weight and length, mean values of SD scores for weight and height remained relatively unchanged up until 2 y of age, thereafter increasing gradually up to 7 y of age, leaving 4/46 (8%) and 4/46 (8%) below -2 SD for weight and height, respectively. The pattern of changes in length/height and weight over time did not differ between those infants with abnormal BFC and those with normal BFC. The abnormal fetal aortic waveform was not related to rate of early catch-up growth or to height or weight at 7 y of age after adjustment for deviation in growth at birth. The magnitude of deficit in weight and length at birth was more predictive of subsequent growth.