Evaluation of cerebral oxygenation and perfusion in small for gestational age neonates and neurodevelopmental outcome at 24–36 months of age

AbstractObjectiveTo examine cerebral oxygenation and perfusion in small for gestational age (SGA) compared with appropriate for gestational age (AGA) neonates during the first postnatal week, and to investigate any association with neurodevelopmental outcomes at 24–36 months of age.MethodsA prospective matched case-control study was conducted evaluating cerebral oxygenation and perfusion, using near-infrared spectroscopy (NIRS), between SGA and AGA neonates, during the first postnatal week. A neurodevelopmental assessment with Bayley-III was performed at 24–36 months of age.ResultsForty-eight SGA and 48 AGA neonates of similar gestation (32.8 ± 2.1 vs. 32.5 ± 1.9) were enrolled. On the first postnatal day, the cerebral oxygenation was equal between SGA and AGA neonates (71 ± 7% vs. 72 ± 8%); however, in the subgroup analysis, males had higher oxygenation compared to female SGA neonates (73 ± 7% vs. 69 ± 7%, P = 0.04). Cerebral perfusion was significantly higher in SGA neonates on the first postnatal day (1.4 ± 0.6 vs. 1.1 ± 0.5, P = 0.04), but this difference was diminished on subsequent measurements. There were no significant differences between the SGA and AGA infants regarding the composite cognitive, communication and motor index scores. The length of mechanical ventilation and late-onset sepsis were significant risk factors affecting the cognitive and communication composite index scores, respectively.ConclusionCerebral oxygenation was equal between SGA and AGA neonates, while cerebral perfusion was transiently increased in SGA neonates during the first postnatal day. There was no significant association of cerebral oxygenation and perfusion with neurodevelopmental outcomes.

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Placental findings in late-onset small for gestational age births without Doppler signs of placental insufficiency and their impact in neurodevelopmental outcome

Placenta ◽

10.1016/j.placenta.2014.06.125 ◽

2014 ◽

Vol 35 (9) ◽

pp. A38

Author(s):

Alfons Nadal ◽

Miguel Parra-Saavedra ◽

Francesca Crovetto ◽

Stefania Triunfo ◽

Stefan Savchev ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Late Onset ◽

Neurodevelopmental Outcome ◽

Placental Insufficiency

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Neurodevelopmental Outcome of Infants with Gastroschisis at One-Year Follow-Up

Journal of Neonatal Surgery ◽

10.47338/jns.v4.165 ◽

2015 ◽

Vol 4 (2) ◽

Author(s):

Vishal Gupta ◽

Amit Trivedi ◽

Karen Walker ◽

Andrew JA Holland

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Surgical Repair ◽

Neurodevelopmental Outcome ◽

Control Group ◽

Developmental Assessment ◽

Neurodevelopmental Outcomes ◽

One Year ◽

Assessment Results

Objective: Gastroschisis is a congenital malformation of the abdominal wall and may be associated with significant neonatal mortality and morbidity. The primary objective of this study was to describe the neurodevelopmental outcomes of neonates with this condition.Methods: Medical records of all neonates admitted with a diagnosis of gastroschisis to a tertiary surgical unit from October 2006 to August 2011 were retrospectively reviewed. Demographic and clinical variables were collated along with developmental assessment results at one-year follow-up. Developmental assessment results were compared with case matched healthy control neonates of similar gestational age and birth weight.Results: Of 20 patients in the study, 16 had simple and four had complex gastroschisis. Mean birth weight was 2.29 kg with a mean gestational age of 35.7 weeks. The majority of neonates underwent primary surgical repair, while 15% had a silo followed by surgical repair. Neonates with gastroschisis did not significantly differ from the control group in neurodevelopmental outcomes. Receptive and expressive language delay was found in gastroschisis is attributable to small for gestational age rather than the malformation per se.Conclusions: These data suggest that neurodevelopmental outcomes at one year of age in children with gastroschisis were associated with being small for gestational age rather than the malformation.

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Perinatal Outcome and its Prediction Using Longitudinal Feto-Maternal Doppler Follow-Up in Late Onset Small for Gestational Age Fetuses – A Prospective Cohort Study

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1493-2367 ◽

2021 ◽

Author(s):

Silvia M. Lobmaier ◽

Oliver Graupner ◽

Javier U. Ortiz ◽

Bernhard Haller ◽

Christina Ried ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Prospective Cohort ◽

Perinatal Outcome ◽

Late Onset ◽

Induction Of Labor ◽

University Hospital ◽

Operative Delivery ◽

Longitudinal Measurements ◽

Cesarean Delivery Rate

Abstract Purpose To describe the perinatal outcome of a prospective cohort of late-onset small-for-gestational-age (SGA) fetuses and to test adverse perinatal outcome (APO) prediction using Doppler measurements. Methods Singleton pregnancies from 32 weeks with suspicion of SGA (followed-up each 2 weeks) and randomly selected healthy controls at a university hospital were included. The whole SGA group was divided into the FGR subgroup or SGA percentile 3–10 subgroup. The following Doppler measurements were evaluated prospectively: umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, cerebro-placental ratio (CPR), and mean uterine artery (mUtA) PI. APO was defined as arterial cord blood pH ≤ 7.15 and/or 5-minute Apgar ≤ 7 and/or emergency operative delivery and/or admission to the neonatal unit. Induction of labor was indicated according to a stage-based protocol. Results A total of 149 SGA and 143 control fetuses were included. The number of operative deliveries was similar between both groups (control: 29 %, SGA: 28 %), especially the cesarean delivery rate after the onset of labor (11 % vs. 10 %). Most SGA cases ended up in induction of labor (61 % vs. 31 %, p < 0.001). The areas under the curve (AUC) for APO prediction were similar using the last UA PI, MCA PI, CPR, and mUtA PI and barely reached 0.60. The AUC was best for the FGR subgroup, using the minimal CPR or maximum mUtA PI z-score of all longitudinal measurements (AUC = 0.63). Conclusion SGA fetuses do not have a higher rate of operative delivery if managed according to a risk stratification protocol. Prediction of APO is best for SGA and FGR using the “worst” CPR or mUtA PI but it remains moderate.

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Comparison of neonatal outcomes of small for gestational age and appropriate for gestational age preterm infants born at 28–36 weeks of gestation: a multicentre study in Ethiopia

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000740 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000740

Author(s):

Netsanet Workneh Gidi ◽

Robert L Goldenberg ◽

Assaye K Nigussie ◽

Elizabeth McClure ◽

Amha Mekasha ◽

...

Keyword(s):

Preterm Infants ◽

Gestational Age ◽

Small For Gestational Age ◽

Late Onset ◽

Early Recognition ◽

Neonatal Outcomes ◽

P Value ◽

Prolonged Hospitalisation ◽

Increased Risk ◽

Appropriate For Gestational Age

PurposeThe aim of this study was to assess morbidity and mortality pattern of small for gestational age (SGA) preterm infants in comparison to appropriate for gestational age (AGA) preterm infants of similar gestational age.MethodWe compared neonatal outcomes of 1336, 1:1 matched, singleton SGA and AGA preterm infants based on their gestational age using data from the study ‘Causes of Illness and Death of Preterm Infants in Ethiopia (SIP)’. Data were analysed using SPSS V.23. ORs and 95% CIs and χ2 tests were done, p value of <0.05 was considered statistically significant.ResultThe majority of the infants (1194, 89%) were moderate to late preterm (32–36 weeks of gestation), 763 (57%) were females. Male preterm infants had higher risk of being SGA than female infants (p<0.001). SGA infants had increased risk of hypoglycaemic (OR and 95% CI 1.6 (1.2 to 2.0), necrotising enterocolitis (NEC) 2.3 (1.2 to 4.1), polycythaemia 3.0 (1.6 to 5.4), late-onset neonatal sepsis (LOS) 3.6 (1.1 to 10.9)) and prolonged hospitalisation 2.9 (2.0 to 4.2). The rates of respiratory distress syndrome (RDS), apnoea and mortality were similar in the SGA and AGA groups.ConclusionNeonatal complications such as hypoglycaemic, NEC, LOS, polycythaemia and prolonged hospitalisation are more common in SGA infants, while rates of RDS and mortality are similar in SGA and AGA groups. Early recognition of SGA status, high index of suspicion and screening for complications associated and timely intervention to prevent complications need due consideration.

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OC20.04: An integrated model with classification criteria to differentiate late-onset fetal growth restriction vs. small-for-gestational age

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.13593 ◽

2014 ◽

Vol 44 (S1) ◽

pp. 47-47 ◽

Cited By ~ 2

Author(s):

F. Figueras ◽

S. Savchev ◽

S. Triunfo ◽

F. Crovetto ◽

E. Gratacós

Keyword(s):

Fetal Growth ◽

Gestational Age ◽

Small For Gestational Age ◽

Fetal Growth Restriction ◽

Late Onset ◽

Integrated Model ◽

Classification Criteria ◽

Growth Restriction

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553 NEURODEVELOPMENTAL OUTCOMES OF PRETERM SMALL FOR GESTATIONAL AGE INFANTS BORN TO MOTHERS WITH AND WITHOUT PREECLAMPSIA.

Journal of Investigative Medicine ◽

10.2310/6650.2005.x0004.552 ◽

2006 ◽

Vol 54 (1) ◽

pp. S174.2-S174

Author(s):

E. E. Rogers ◽

C. Leonard ◽

R. Piecuch

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Neurodevelopmental Outcomes

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Growth and Neurodevelopmental Outcomes at 12 to 18 Months of Corrected Age in Preterm Infants Born Small for Gestational Age

Indian Pediatrics ◽

10.1007/s13312-020-1779-9 ◽

2020 ◽

Vol 57 (4) ◽

pp. 301-304 ◽

Cited By ~ 1

Author(s):

Srinivas Murki ◽

Venkat Reddy Kallem ◽

Jaishree Gururaj ◽

Tanveer Bashir ◽

Tejo Pratap Oleti ◽

...

Keyword(s):

Preterm Infants ◽

Gestational Age ◽

Small For Gestational Age ◽

Neurodevelopmental Outcomes

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Group B Streptococcus (Streptococcus agalactiae)

10.1093/med/9780190604813.003.0019 ◽

2018 ◽

Author(s):

Kirsty Le Doare ◽

Christine E. Jones ◽

Paul T. Heath

Keyword(s):

Early Onset ◽

Late Onset ◽

Group B Streptococcus ◽

Significant Risk ◽

Neonatal Infection ◽

Significant Risk Factor ◽

Invasive Disease ◽

Neurodevelopmental Outcomes ◽

Intrapartum Antibiotic ◽

Group B

Group B Streptococcus (GBS) is a leading cause of early neonatal infection and neonatal mortality, with long-term adverse neurodevelopmental outcomes in up to 50% of survivors of GBS meningitis. GBS has a likely underappreciated role in causing preterm birth and stillbirth. GBS colonizes the vagina and gastrointestinal tract of the pregnant woman, and transmission to the infant occurs during or just before delivery. Although the majority of these infants do not develop invasive disease, maternal colonization is a prerequisite for early onset disease (0–6 days of life, most commonly associated with sepsis and respiratory distress) and a significant risk factor for late onset disease (7–89 days of life, most commonly associated with sepsis and meningitis). The introduction of intrapartum antibiotic prophylaxis has resulted in significant declines in the incidence of early onset disease but provides no protection against late onset disease.

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