Neurodevelopmental outcomes at five years after early-onset fetal growth restriction: Analyses in a Dutch subgroup participating in a European management trial

A. Pels*, O. C. Knaven, B. J. Wijnberg-Williams, M. J.C. Eijsermans, S. M. Mulder-de Tollenaer, C. S.H. Aarnoudse-Moens, C. Koopman-Esseboom, J. van Eyck, J. B. Derks, W. Ganzevoort, A. G. van Wassenaer-Leemhuis

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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 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.

Original languageEnglish
Pages (from-to)63-70
Number of pages8
JournalEuropean Journal of Obstetrics Gynecology and Reproductive Biology
Volume234
DOIs
Publication statusPublished - 1 Mar 2019

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

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