Background and aim Antenatal absent or reverse end-diastolic flow (AREDF) in the umbilical artery (UA) is associated with high perinatal morbidity and mortality. We aimed to assess the neurodevelopment outcome during toddlerhood of very low birth weight preterm infants with AREDF in the UA during pregnancy.
Methods We compared longitudinally collected neurodevelopment outcome data of surviving preterm infants born in our institution in 1996–2010 with birth weight <1500 g and with AREDF in the UA with those of sex-, gestational age-, birth weight-, and birth year-matched infants with prenatal normal UA-Doppler parameters. Neurodevelopment outcome was evaluated at a mean (SD) corrected age of 20.6(8.1) months by the BSID-II and neurological examination.
Results Forty-one infants for both groups were recruited. Neonatal and socio-demographic characteristics of both groups were similar except for the confounders caesarean section, antenatal corticosteroids (higher in AREDF group, p = 0.01 and 0.02, respectively), and mother’s age (lower in AREDF group, p = 0.01). Mean (SD) mental development index of children with AREDF in the UA (81.8, 16.3) was significantly lower (p = 0.02) compared to controls (92.4, 16.3). This result remains significant after adjustment for confounders. No significant differences in the psychomotor development index or in the distribution of cerebral palsy were observed between the two groups.
Conclusion Preterm infants with abnormal antenatal Doppler in the UA have a higher risk for adverse neurodevelopment outcome during toddlerhood compared to sex-, gestational age-, birth weight-, and birth year-matched controls. AREDF in the UA might be considered a prenatal predictor of adverse neurodevelopment outcome in this population.