FETAL BRAIN SPARING IS ASSOCIATED WITH ACCELERATED SHORTENING OF VISUAL-EVOKED POTENTIAL LATENCIES DURING EARLY INFANCY

OBJECTIVE: Our purpose was to assess the effects that fetal growth res triction exerts on the myelination of the developing brain. STUDY DESI GN: Fetal haemodynamic centralization, an adaptive strategy to growth restriction caused by placental insufficiency, was determined by Doppl er ultrasonography. Infants with a raised ratio between umbilical arte ry pulsatility index and cerebral artery pulsatility index are severel y growth restricted. Visual evoked potentials give information on the degree of brain myelination. Shortening of visual evoked potential lat encies is a normal feature of myelination. In a consecutive series of 105 neonates, visual evoked potentials were recorded at the corrected ages of 6 months and 1 year. Correction for possible confounders, such as cranial ultrasonographic findings, gestational age, and head circu mference, was performed. RESULTS: At 6 months, infants with a raised u mbilical artery/cerebral artery pulsatility index ratio have shorter v isual evoked potential latencies. Opposite of neonates with a normal u mbilical artery/cerebral artery ratio, they show no postnatal maturati onal shortening of visual evoked potential latencies. CONCLUSION: Acce lerated neurophysiologic maturation, found in infants with a high umbi lical artery/cerebral artery ratio, might be the result of a beneficia l adaptive process to severe fetal growth restriction.