Fetal growth restriction with brain sparing

Beukers F, Aarnoudse-Moens CSH, van Weissenbruch MM, Ganzevoort W, van Goudoever JB, van Wassenaer-Leemhuis AG. Fetal Growth Restriction with Brain Sparing: Neurocognitive and Behavioral Outcomes at 12 Years of Age. J Pediatr. 2017 Jul 7. pii: S0022-3476(17)30781-3. doi: 10.1016/j.jpeds.2017.06.003. [Epub ahead of print]

Abstract

OBJECTIVE:

To study neurocognitive functions and behavior in children with a history of fetal growth restriction (FGR) with brain sparing. We hypothesized that children with FGR would have poorer outcomes on these domains.

STUDY DESIGN:

Subjects were 12-year-old children with a history of FGR born to mothers with severe early-onset hypertensive pregnancy disorders (n = 96) compared with a normal functioning full term comparison group with a birth weight ≥2500 g (n = 32). Outcome measures were neurocognitive outcomes (ie, intelligence quotient, executive function, attention) and behavior.

RESULTS:

For the FGR group, the mean ratio of the pulsatility index for the umbilical artery/middle cerebral artery (UC-ratio = severity of brain sparing) was 1.42 ± 0.69. The mean gestational age was 31-6/7  ± 2-2/7 weeks. The mean birth weight was 1341  ± 454 g, and the mean birth weight ratio 0.68 ± 0.12. Neurocognitive outcomes were comparable between groups. Parents of children with FGR reported more social problems (mean T-score 56.6 ± 7.7; comparison 52.3 ± 4.3, P < .001, effect size = 1, 95% CI 0.52-1.46) and attention problems (mean T-score 57.3 ± 6.9; comparison 53.6 ± 4.2, P = .004, effect size = 0.88, 95% CI 0.42-1.33). UC-ratio was not associated with any of the outcomes, but low parental education and lower birth weight ratio were.

CONCLUSIONS:

In this prospective follow-up study of 12-year-old children with a history of FGR and confirmed brain sparing, neurocognitive functions were comparable with the comparison group, but parent-reported social and attention problem scores were increased.

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This research work was performed to analyze the neurocognitive functions and behavior in children with a history of fetal growth restriction (FGR) with brain sparing. Investigations displayed comparable neurocognitive functions between children with a history of FGR and confirmed brain sparing and the control group. However, parent–reported social and attention problem scores were increased in children with a history of FGR and brain sparing.

Methods

This study consisted of 12–year–old children with a history of FGR born to mothers with severe early–onset hypertensive pregnancy disorders (n = 96) and a normal functioning full term comparison group with a birth weight ≥2500 g (n = 32).

Outcome measures were neurocognitive outcomes (ie, intelligence quotient, executive function, attention) and behavior.

Results

The mean ratio of the pulsatility index for the umbilical artery/middle cerebral artery (UC–ratio = severity of brain sparing) was 1.42 ± 0.69, for the FGR group.

31–6/7 ± 2–2/7 weeks was the mean gestational age.

The mean birth weight was 1341 ± 454 g, and the mean birth weight ratio 0.68 ± 0.12.

Between groups, neurocognitive outcomes were comparable.

Parents of children with FGR reported more social problems (mean T–score 56.6 ± 7.7; comparison 52.3 ± 4.3, P < .001, effect size = 1, 95% CI 0.52–1.46) and attention problems (mean T–score 57.3 ± 6.9; comparison 53.6 ± 4.2, P = .004, effect size = 0.88, 95% CI 0.42–1.33).

UC–ratio was not associated with any of the outcomes, but low parental education and lower birth weight ratio were.

https://www.mdlinx.com/neurology/medical-news-article/2017/07/11/pre-eclampsia-fetal-growth-restriction-very/7242446/?category=latest&page_id=6