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Blood flow velocities in the cerebral arteries and descending aorta in small-for-dates infants
1Department of Neonatology, Japan Red Cross Medical Center, Tokyo.
Insights
Infants small-for-dates (SFD) showed lower resistive indices (RI) in brain arteries (MCA, ACA, BA) and higher RI in the descending aorta (DA) compared to appropriate-for-dates (AFD) infants. This suggests a "brain sparing" effect in SFD neonates.
Area of Science:
- Neonatal Physiology
- Pediatric Neurology
- Vascular Ultrasound
Background:
- Maternal pregnancy-induced hypertension can cause fetal growth restriction.
- Small-for-dates (SFD) infants exhibit altered circulatory patterns.
- Understanding neonatal hemodynamics is crucial for clinical management.
Purpose of the Study:
- To compare cerebrovascular and aortic resistive indices (RI) between SFD and appropriate-for-dates (AFD) infants.
- To investigate potential "brain sparing" effects in SFD neonates.
- To assess the utility of Doppler ultrasound in evaluating circulatory changes in SFD infants.
Main Methods:
- Doppler ultrasound was used to measure resistive indices (RI) in the anterior cerebral artery (ACA), basilar artery (BA), middle cerebral artery (MCA), and descending aorta (DA).
- Measurements were performed in 15 SFD infants and 20 matched AFD infants within 48 hours after birth.
- Statistical analysis compared RI values between the two infant groups.
Main Results:
- SFD infants demonstrated significantly lower RI in the MCA, ACA, and BA compared to AFD infants.
- SFD infants exhibited a significantly higher RI in the DA than AFD infants.
- These findings suggest altered cerebral blood flow regulation in SFD neonates.
Conclusions:
- The observed RI changes in SFD infants are consistent with a "brain sparing" phenomenon, prioritizing blood flow to the brain.
- Doppler ultrasound can effectively identify hemodynamic alterations in SFD neonates.
- Further research is warranted to explore the long-term implications of these circulatory changes.
Abstract:
Resistive indices (RI) in the anterior cerebral artery (ACA), basilar artery (BA), middle cerebral artery (MCA) and descending aorta (DA) were obtained in 15 small-for-dates (SFD) infants who were, growth retarded because of maternal pregnancy-induced hypertension and in 20 appropriate-for-dates (AFD) infants matched for gestational age between 24 h and 48 h after birth. The RIs in the MCA, ACA and BA were significantly lower, while the RI in the DA was significantly higher, in the SFD infants than in the AFD infants. These changes in RIs in the SFD infants might be similar to the "brain sparing" effect as reported in growth-retarded fetuses.