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Does chronic prenatal Doppler pathology predict feeding difficulties in neonates?
Susanne Müller-Egloff1, Alexander Strauss, Veronika Spranger
1Clinic of Obstectrics and Gynecology, Klinikum Ludwig-Maximilians-University Munich Grosshadern, Munich, Germany.
Acta Paediatrica (Oslo, Norway : 1992)
|November 24, 2005
Summary
Infants with decreased prenatal umbilical flow velocity (DEDFV) experienced slower enteral feeding advancements, but this did not increase necrotizing enterocolitis (NEC) risk. These findings suggest prenatal Doppler findings alone do not warrant delaying infant feeding.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Gastroenterology
Background:
- Compromised fetomaternal circulation can affect neonatal outcomes.
- Prenatal Doppler velocimetry identifies fetuses with altered umbilical artery flow.
- Brain-sparing pathology indicates fetal distress due to reduced oxygenation.
Purpose of the Study:
- To investigate feeding problems in infants with decreased prenatal end-diastolic umbilical flow velocity (DEDFV) or brain-sparing pathology.
- To assess the risk of feeding issues in neonates with compromised fetomaternal circulation before critical flow changes.
Main Methods:
- Retrospective case-control study comparing infants with DEDFV/brain-sparing to gestational age-matched controls.
- Enteral feeding data and clinical outcomes were analyzed.
- Standardized enteral feeding protocols were applied to all infants.
Main Results:
- Infants with DEDFV were smaller than controls.
- Enteral feeding advancement differed significantly between DEDFV infants and controls.
- No significant difference in the incidence of necrotizing enterocolitis (NEC) was observed.
- Severely affected infants (GA<30 wk with brain sparing) showed delayed enteral feeding and parenteral nutrition support.
Conclusions:
- Infants with prenatal distress signs (brain sparing) received enteral feeds more slowly.
- A predisposition to NEC was not demonstrated in infants with DEDFV or brain sparing.
- Prenatal Doppler findings alone are not sufficient justification for delaying enteral feedings in neonates.