Soghra Khazardoost1, Fahimeh Ghotbizadeh1, Behrokh Sahebdel2, Fatemeh Nasiri Amiri3, Masoumeh Shafaat4, Zahra Akbarian-Rad5, Zeinab Pahlavan6. 1. Department of Perinatology, Tehran University of Medical Sciences, Maternal Fetal Neonatal Research Center, Imam Khomeini Hospital, Tehran, Iran. 2. Department of Perinatology, Tehran University of Medical Sciences, Emam Khomeini Medical Complex, Vali-Asr Hospital, Tehran, Iran. 3. Department of Midwifery, Fatemeh Zahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran. 4. Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Emam Khomeini Medical Complex, Vali-Asr Hospital, Tehran, Iran. 5. Department of Pediatrics, Non-Communicable Pediatric Disease Research Center, Babol University of Medical Sciences, Babol, Iran. 6. Department of Perinatology, Tehran University of Medical Sciences, Emam Khomeini Medical Complex, Vali-Asr Hospital, Tehran, Iran, dr.z.pahlavan@gmail.com.
Abstract
BACKGROUND: Doppler parameters have been commonly used for the prediction of neonatal outcomes. However, controversies exist with regard to the value of Doppler parameters in predicting the risk of neurological outcomes among neonates. OBJECTIVE: This prospective cohort study attempted to assess the value of Doppler parameters in predict ing cranial ultrasound abnormalities (CUAs) in intrauterine growth restriction (IUGR) among fetuses at 28-34 weeks of gestation. METHODS: This was a prospective cohort study of 83 delivered IUGR fetuses and 75 control fetuses matched for gestational age (GA). The value of mentioned Doppler parameters and GA in predicting the risk of CUAs, including periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH), and basal ganglia lesions (BGLs), was analyzed. RESULTS: The incidence of CUAs among IUGR fetuses (66.3%) was significantly higher (p < 0.001) than in the control group (40%). The incidence of neonatal mortality among IUGR fetuses was significantly higher (p < 0.001) than in the control group. Absent or reversed end-diastolic velocity (AREDV) in the umbilical artery (UA) and the ductus venosus (DV) after adjustment for GA was associated with increased odds of IVH, PVL, BGLs, and any CUA. CONCLUSIONS: GA at birth and AREDV in the UA and the DV within 1 week before childbirth were reliable predictors of CUAs during the neonatal period.
BACKGROUND: Doppler parameters have been commonly used for the prediction of neonatal outcomes. However, controversies exist with regard to the value of Doppler parameters in predicting the risk of neurological outcomes among neonates. OBJECTIVE: This prospective cohort study attempted to assess the value of Doppler parameters in predict ing cranial ultrasound abnormalities (CUAs) in intrauterine growth restriction (IUGR) among fetuses at 28-34 weeks of gestation. METHODS: This was a prospective cohort study of 83 delivered IUGR fetuses and 75 control fetuses matched for gestational age (GA). The value of mentioned Doppler parameters and GA in predicting the risk of CUAs, including periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH), and basal ganglia lesions (BGLs), was analyzed. RESULTS: The incidence of CUAs among IUGR fetuses (66.3%) was significantly higher (p < 0.001) than in the control group (40%). The incidence of neonatal mortality among IUGR fetuses was significantly higher (p < 0.001) than in the control group. Absent or reversed end-diastolic velocity (AREDV) in the umbilical artery (UA) and the ductus venosus (DV) after adjustment for GA was associated with increased odds of IVH, PVL, BGLs, and any CUA. CONCLUSIONS: GA at birth and AREDV in the UA and the DV within 1 week before childbirth were reliable predictors of CUAs during the neonatal period.