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Abnormal fetal aortic velocity waveform and minor neurological dysfunction at 7 years of age
1Department of Pediatrics, University of Lund, Malmö General Hospital, Sweden.
Insights
Abnormal fetal aortic blood flow velocity is linked to a higher risk of minor neurological dysfunction in children. This finding highlights the predictive value of fetal hemodynamic evaluation for postnatal neurological development.
Area of Science:
- Perinatology
- Neurodevelopmental Pediatrics
- Fetal Medicine
Background:
- Fetal growth restriction is associated with adverse neurodevelopmental outcomes.
- Assessing fetal well-being through hemodynamic parameters is crucial for predicting postnatal health.
Purpose of the Study:
- To investigate the association between fetal aortic blood flow velocity patterns and the incidence of minor neurological dysfunction (MND) at age 7.
- To determine if abnormal fetal hemodynamics predict MND in offspring.
Main Methods:
- Prospective study of 178 pregnancies with measurements of fetal aortic blood flow velocity and fetal growth.
- Neurological examinations were performed at 7 years of age on 149 children, focusing on minor neurological dysfunction.
- Logistic regression analysis was used to identify predictors of MND-2, the more severe form of MND.
Main Results:
- A higher frequency of MND-2 was observed in fetuses with abnormal blood flow class (BFC) III (absent or reversed end-diastolic flow) compared to those with normal BFC 0.
- Abnormal blood flow class was the most significant predictor of MND-2, both independently and when combined with other factors.
- The study identified a significant association between abnormal fetal aortic velocity waveforms and adverse neurodevelopmental outcomes.
Conclusions:
- Abnormal fetal aortic blood flow velocity patterns are associated with an increased risk of minor neurological dysfunction.
- Hemodynamic evaluation of the fetus during pregnancy has predictive value for postnatal neurological development.
- These findings support the use of fetal hemodynamic assessment as a tool for identifying infants at risk for neurodevelopmental issues.
Abstract:
Measurements of fetal aortic blood flow velocity and fetal growth were performed in 178 pregnancies. In 87 cases, the estimated fetal weight was > or = 2 SD below the gestational age-related mean of the population. Three fetuses died in utero. In 149 children (85%), a neurological examination was performed at 7 years of age with special emphasis on minor neurological dysfunction. The frequency of the more severe form of minor neurological dysfunction, MND-2, was higher in the group with blood flow class (BFC) III (absent or reversed end-diastolic flow velocity (8/21) than in the group with BFC 0 (normal velocity waveform) (14/105). Logistic regression analysis revealed that abnormal blood flow class, both independently and in combination with other factors, was the most significant predictor of MND-2. The association found between abnormal fetal aortic velocity waveforms and adverse outcome in terms of minor neurological dysfunction suggests that hemodynamic evaluation of the fetus has a predictive value regarding postnatal neurological development.