Neurodevelopmental outcomes at five years after early-onset fetal growth restriction: Analyses in a Dutch subgroup participating in a European management trial
Pels, A.; Knaven, O. C.; Wijnberg-Williams, B. J.; Eijsermans, M. J.C.; Mulder-de Tollenaer, S. M.; Aarnoudse-Moens, C. S.H.; Koopman-Esseboom, C.; van Eyck, J.; Derks, J. B.; Ganzevoort, W.; van Wassenaer-Leemhuis, A. G.
(2019) European Journal of Obstetrics Gynecology and Reproductive Biology, volume 234, pp. 63 - 70
(Article)
Abstract
OBJECTIVE: The objective of this study is to explore developmental outcomes at five years after early-onset fetal growth restriction (FGR). STUDY DESIGN: Retrospective data analysis of prospective follow-up of patients of three Dutch centres, who participated in a twenty centre European randomized controlled trial on timing of delivery in early-onset
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FGR. Developmental outcome of very preterm infants born after extreme FGR is assessed at (corrected) age of five. RESULTS: Seventy-four very preterm FGR children underwent follow-up at the age of five. Mean gestational age at birth was 30 weeks and birth weight was 910 g, 7% had a Bayley score <85 at two years. Median five years' FSIQ was 97, 16% had a FSIQ < 85, and 35% had one or more IQ scores <85. Motor score ≤ 7 on movement ABC-II (M-ABC-II-NL) was seen in 38%. Absent or reversed end-diastolic flow, gestational age at delivery, birthweight and neonatal morbidity were related to an FSIQ < 85. Any abnormal IQ scale score was related to birthweight, male sex and severity of FGR, and abnormal motor score to male sex and bronchopulmonary dysplasia (BPD). CONCLUSIONS: Overall, median cognitive outcome at five years was within normal range, but 35% of the children had any abnormal IQ score at age five, depending on the IQ measure, and motor impairment was seen in 38% of the children. GA at delivery, birthweight, EDF prior to delivery and neonatal morbidity were the most important risk factors for cognitive outcomes.
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Keywords: Adult, Child, Preschool, Female, Fetal Growth Retardation/epidemiology, Follow-Up Studies, Gestational Age, Humans, Infant, Very Low Birth Weight, Intelligence Tests, Male, Netherlands, Neurodevelopmental Disorders/epidemiology, Pregnancy, Prospective Studies, Retrospective Studies, Risk Factors, Young Adult, Journal Article, Multicenter Study
ISSN: 0301-2115
Publisher: Elsevier Ireland Ltd
Note: Funding Information: None. Publisher Copyright: © 2019 Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
(Peer reviewed)