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Does fetal growth restriction lead to increased brain injury as detected by neonatal cranial ultrasound in premature infants?
Author(s) -
Malhotra Atul,
Yahya Zamir,
Sasi Arun,
Jenkin Graham,
Ditchfield Michael,
Polglase Graeme R,
Miller Suzanne L
Publication year - 2015
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12910
Subject(s) - medicine , hydrocephalus , intraventricular hemorrhage , intrauterine growth restriction , fetus , gestation , periventricular leukomalacia , gestational age , pediatrics , obstetrics , retrospective cohort study , incidence (geometry) , pregnancy , surgery , physics , biology , optics , genetics
Aim Intra‐uterine growth restriction ( IUGR ) is an important cause for prematurity as well as a significant risk factor for neurodevelopmental deficits. In this study, we aimed to examine the association between IUGR and early brain injury on neonatal cranial ultrasound in preterm infants. Methods This retrospective cohort study examined the relationship between IUGR and neonatal cranial ultrasound findings in preterm infants <32 weeks gestation with IUGR , compared with gestation and year of birth‐matched appropriately grown infants, in a tertiary level neonatal unit. Primary outcome was incidence and severity of intraventricular haemorrhage ( IVH ), periventricular leucomalacia ( PVL ) and hydrocephalus detected by cranial ultrasound in the neonatal period. Results A total of 153 IUGR and 306 non‐ IUGR preterm infants <32 weeks were included. The rates of IVH (21.6% vs. 23.9%), severe IVH (3.9% vs. 4.6%), PVL (8.4% vs. 9.4%), cystic PVL (2.6% vs. 0%) and hydrocephalus (0.7% vs. 0.3%) were similar in the two groups. Composite outcome of death and severe brain injury (severe IVH , cystic PVL and hydrocephalus) was greater (20.2% vs. 9.1%, P = 0.001) in IUGR infants. Conclusion IUGR did not lead to increased neonatal brain injury on cranial ultrasound but was associated with increased mortality. Advanced neonatal neuroimaging techniques may be necessary to estimate risk and to provide prognostic information of adverse neurological outcomes in this vulnerable population.