TY - JOUR
T1 - Neurodevelopmental outcomes at five years after early-onset fetal growth restriction
T2 - Analyses in a Dutch subgroup participating in a European management trial
AU - Pels, A.
AU - Knaven, O. C.
AU - Wijnberg-Williams, B. J.
AU - Eijsermans, M. J.C.
AU - Mulder-de Tollenaer, S. M.
AU - Aarnoudse-Moens, C. S.H.
AU - Koopman-Esseboom, C.
AU - van Eyck, J.
AU - Derks, J. B.
AU - Ganzevoort, W.
AU - van Wassenaer-Leemhuis, A. G.
N1 - Funding Information:
None.
Publisher Copyright:
© 2019
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - 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.
AB - 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.
KW - Adult
KW - Child, Preschool
KW - Female
KW - Fetal Growth Retardation/epidemiology
KW - Follow-Up Studies
KW - Gestational Age
KW - Humans
KW - Infant, Very Low Birth Weight
KW - Intelligence Tests
KW - Male
KW - Netherlands
KW - Neurodevelopmental Disorders/epidemiology
KW - Pregnancy
KW - Prospective Studies
KW - Retrospective Studies
KW - Risk Factors
KW - Young Adult
UR - http://www.scopus.com/inward/record.url?scp=85060012682&partnerID=8YFLogxK
U2 - 10.1016/j.ejogrb.2018.12.041
DO - 10.1016/j.ejogrb.2018.12.041
M3 - Article
C2 - 30660941
AN - SCOPUS:85060012682
SN - 0301-2115
VL - 234
SP - 63
EP - 70
JO - European Journal of Obstetrics Gynecology and Reproductive Biology
JF - European Journal of Obstetrics Gynecology and Reproductive Biology
ER -