Ultrasound Obstet Gynecol. 2020 Mar 25. doi: 10.1002/uog.22025.
To investigate the association of absent or reversed end diastolic flow (ARED) in umbilical artery Doppler ultrasound with poor neurological outcome at age 2 after very preterm birth associated with suspected fetal growth restriction (FGR) or maternal hypertensive disorders.
The study population included all very preterm singletons born because of suspected FGR or maternal hypertensive disorders included in EPIPAGE-2, a prospective, nationwide, population-based cohort of preterm births in France in 2011. We analyzed the association of ARED in the umbilical artery with severe or moderate neuromotor or sensory disabilities, and with an Age and Stages Questionnaire (ASQ) score below the threshold at age 2. ASQ is used to identify children at risk of developmental delay needing reinforced follow-up and further evaluation. We performed univariate and two-level multivariable logistic regression analyses.
The analysis included 484 children followed up at 2 years of age for whom prenatal umbilical Doppler ultrasound was available. Among them, 8 (1.5%) had severe or moderate neuromotor or sensory disabilities, and 156 (43.9%) had an ASQ score below the threshold. Compared to normal or reduced end diastolic flow in the umbilical artery (n=305), ARED (n=179) was associated with either severe or moderate neuromotor or sensory disabilities (adjusted OR 11.3, 95% CI 1.4-93.4) but not with an ASQ score below the threshold (adjusted aOR 1.2, 95% CI 0.8-1.9).
Among children born before 32 weeks of gestation because of suspected fetal growth restriction or hypertensive disorder who survived until age 2, prenatal ARED in the umbilical artery was associated with more frequent moderate or severe neuromotor or sensory disabilities. This article is protected by copyright. All rights reserved.