Behavioural problems at the age of eleven years in preterm-born children with or without fetal brain sparing: a prospective cohort study.

Abstract:

BACKGROUND:In severe intrauterine growth restriction (IUGR) due to placental insufficiency a haemodynamic adaptation occurs, resulting in preferential blood flow to the fetal brain (brain sparing). With Doppler ultrasound an increased ratio between the umbilical and the cerebral artery pulsatility index (U/C ratio) can be demonstrated. IUGR is associated with impaired neurodevelopmental outcome. OBJECTIVE:Evaluation of the effect of fetal brain sparing on behavioural problems at eleven years in premature born children. METHODS:Prospective cohort study in premature children born in 1989, with a gestational age of 26 0/7 to 33 0/7 weeks. An U/C ratio>0.72 was defined as brain sparing. Behavioural problems were assessed with the parent-reported Child Behaviour Check List (CBCL) and the Teacher's Report Form (TRF). T scores >60 for total problem score and subscales of internalizing and externalizing behaviour, were considered abnormal. RESULTS:Ninety-eight of the 116 survivors were assessed, of which 31 with antenatally established fetal brain sparing. According to the CBCL-total problem score 23.3% of the premature born babies in the brain sparing group had behavioural problems compared with 22.8% of those without brain sparing. According to the TRF-total problem score the percentages were 21.4% and 20.0%, respectively. Logistic regression analysis failed to show a significant association of U/C ratio with behavioural problems. In this model oxygen dependency at 28 days, IQ<85 at five years, cranial ultrasound abnormalities, fetal growth ratio<0.80, Apgar scores<7 after 5 min and birth weight

journal_name

Early Hum Dev

journal_title

Early human development

authors

van den Broek AJ,Kok JH,Houtzager BA,Scherjon SA

doi

10.1016/j.earlhumdev.2010.04.007

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

379-84

issue

6

eissn

0378-3782

issn

1872-6232

pii

S0378-3782(10)00097-6

journal_volume

86

pub_type

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