Dilesh Kohat1, Anish Keepanasseril2, Palanivel Chinnakali3, Nivedita Mondal4, B Vishnu Bhat1. 1. Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. 2. Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. 3. Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. 4. Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. nive.m8@gmail.com.
Abstract
OBJECTIVE: To assess the neurodevelopmental outcome of preterm neonates with absent/reversed end diastolic flow (A/REDF) in umbilical artery Doppler at 1 year of corrected age. METHODS: A cohort of 70 preterm newborns with fetal growth restriction (FGR), defined as estimated fetal weight (EFW) <10th centile, confirmed by birthweight <10th centile, along with A/REDF in the umbilical artery Doppler was followed up till 1 year of corrected age (CA). An equal number of gestation and gender matched preterm newborns with birthweight >10th centile [appropriate for gestational age (AGA)] and normal antenatal ultrasound were taken as controls. Primary outcome was a composite of death or major neurodevelopmental disability (NDD) at 1 year of corrected age. Matched analysis was performed. RESULTS: A total of 140 newborns were enrolled, of which, 20 expired and 8 were lost to follow-up. The primary outcome (death/major NDD) occurred in 26.8% of the FGR (A/REDF) newborns as compared to 9.3% of their AGA counterparts (RR-2.83, p = 0.02, 95% CI:1.11-7.18). Mean motor quotient in Development Assessment Scale for Indian Infants (DASII) at 1 year of corrected age was significantly lower in FGR (A/REDF) infants (91 ± 13.6 vs. 96.3 ± 7.1, p < 0.05). Multiple other co-morbidities were also significantly more among these newborns. CONCLUSIONS: Preterm newborns with FGR and A/REDF are at significantly increased risk of death/major NDD at 1 year of corrected age.
OBJECTIVE: To assess the neurodevelopmental outcome of preterm neonates with absent/reversed end diastolic flow (A/REDF) in umbilical artery Doppler at 1 year of corrected age. METHODS: A cohort of 70 preterm newborns with fetal growth restriction (FGR), defined as estimated fetal weight (EFW) <10th centile, confirmed by birthweight <10th centile, along with A/REDF in the umbilical artery Doppler was followed up till 1 year of corrected age (CA). An equal number of gestation and gender matched preterm newborns with birthweight >10th centile [appropriate for gestational age (AGA)] and normal antenatal ultrasound were taken as controls. Primary outcome was a composite of death or major neurodevelopmental disability (NDD) at 1 year of corrected age. Matched analysis was performed. RESULTS: A total of 140 newborns were enrolled, of which, 20 expired and 8 were lost to follow-up. The primary outcome (death/major NDD) occurred in 26.8% of the FGR (A/REDF) newborns as compared to 9.3% of their AGA counterparts (RR-2.83, p = 0.02, 95% CI:1.11-7.18). Mean motor quotient in Development Assessment Scale for Indian Infants (DASII) at 1 year of corrected age was significantly lower in FGR (A/REDF) infants (91 ± 13.6 vs. 96.3 ± 7.1, p < 0.05). Multiple other co-morbidities were also significantly more among these newborns. CONCLUSIONS: Preterm newborns with FGR and A/REDF are at significantly increased risk of death/major NDD at 1 year of corrected age.