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Persistent fetal circulation. Neurodevelopmental outcome
Insights
Persistent fetal circulation (PFC) can lead to long-term neurodevelopmental issues in children. Early auditory screening and monitoring neurologic status are crucial for identifying potential hearing loss and developmental delays in infants with PFC.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Neurology
Background:
- Persistent fetal circulation (PFC) is a critical condition in neonates.
- Long-term neurodevelopmental outcomes for children with PFC require further investigation.
- Identifying early risk factors for developmental issues in PFC patients is essential.
Purpose of the Study:
- To evaluate the long-term neurodevelopmental outcomes in children with a history of persistent fetal circulation (PFC).
- To identify correlations between specific factors and the development of neurosensory hearing loss in this cohort.
- To recommend early diagnostic strategies for hearing loss and developmental delays in infants with PFC.
Main Methods:
- A longitudinal follow-up study of forty children diagnosed with persistent fetal circulation (PFC).
- Clinical examinations including neurologic assessments and hearing evaluations were conducted one to four years post-diagnosis.
- Correlation analysis was performed to identify factors associated with neurosensory hearing loss.
Main Results:
- At follow-up, 40% of children with PFC were normal, while significant percentages exhibited neurosensory hearing loss (20%), neurologic abnormalities (15%), and speech impairments (7.5%).
- Neurosensory hearing loss was correlated with maternal insulin-dependent diabetes, specific Brazelton scale findings (hand-to-mouth facility), and eight-month neurologic status.
- Three children had clinically suspect speech, and one experienced a delay in motor development.
Conclusions:
- Children with a history of persistent fetal circulation (PFC) are at significant risk for long-term neurodevelopmental sequelae, particularly hearing loss.
- Early identification of hearing loss can be improved by neonatal auditory behavioral response testing, eight-month neurologic assessments, and attention to parental concerns regarding speech development.
- Neonatal and infancy auditory screening are strongly recommended for all infants experiencing PFC during the neonatal period.
Abstract:
Forty children who had persistent fetal circulation (PFC) were followed up for one to four years. At the most recent examination, 16 (40%) were normal, eight (20%) had neurosensory hearing loss, three (7.5%) were profoundly impaired, six (15.0%) had suspect or abnormal results of neurologic examinations exclusive of hearing loss, three (7.5%) had speech impairment and normal hearing, and one had a delay in motor development. The remaining three had clinically suspect speech. Neurosensory hearing loss correlated only with having a mother with insulin-dependent diabetes, hand-to-mouth facility on the Brazelton scale, and eight-month neurologic status. Earlier diagnosis of hearing loss may be facilitated by testing of neonatal auditory behavioral responses, neurologic status at eight months, and by attention to parental concern about abnormal speech development. Neonatal and infancy auditory screening are recommended in children who have PFC in the neonatal period.