Childhood cognitive development after fetal growth restriction.

Area of Science:

• Perinatal medicine
• Developmental pediatrics
• Fetal imaging

Background:

• Low-birth-weight (LBW) infants are at risk for developmental delays.
• Prenatal Doppler ultrasound of umbilical artery (UA) and internal carotid artery (ICA) can assess fetal well-being.
• Fetal growth restriction (FGR) and small-for-gestational age (SGA) are common in LBW neonates.

Purpose of the Study:

• To investigate the association between prenatal UA and ICA Doppler findings and cognitive development in LBW children.
• To compare cognitive outcomes at 3 and 6 years in LBW children classified as SGA versus FGR based on Doppler findings.

Main Methods:

• A cohort of 209 LBW children (born >28 weeks gestation) was studied.
• Prenatal UA and ICA Doppler resistance indices (RI) were assessed within 2 weeks of delivery.
• Cognitive ability was evaluated at 3 and 6 years using the Stanford-Binet Intelligence Scale (SBIS).

Main Results:

• Children were categorized as SGA (normal Doppler, n=122) or FGR (abnormal Doppler, n=87).
• Mean SBIS scores at 3 years (109.4) and 6 years (110.5) did not differ between SGA and FGR groups.
• The proportion of children with delayed development (SBIS < 85) was similar in both groups at 3 years (10.5% overall).

Conclusions:

• Abnormal prenatal UA and ICA Doppler findings are not predictive of lower cognitive development scores in LBW children.
• Third-trimester delivery in LBW infants with abnormal Doppler findings does not appear to negatively impact cognitive outcomes at 3 and 6 years.