Neonatal and neurodevelopmental outcome in infants born before 30 weeks ofgestation with absent or reversed end-diastolic flow velocities in the umbilical artery

The objective of our study was to examine the outcome of infants born at a gestational age < 30 weeks with absent or reversed end-diastolic flow veloc ity (AREDFV) in the umbilical artery in comparison with gestational age-mat ched eutrophic controls. A group of 40 infants who had AREDFV were matched for gestational age and date of birth with 40 appropriate for gestational a ge infants. Perinatal outcome variables were retrospectively reviewed. In 1 6 out of the 40 matched pairs, a standardized neurological examination was done and, depending on age, the Kaufman Assessment Battery for Children or the Bayley Scales of Infant Development were applied at a corrected age of 13 to 100 months to assess neurodevelopmental outcome. The results were com pared using Fisher's Exact Test or Mann Whitney U Tests as appropriate. In the AREDFV group, 26/40 (65%) survived until discharge compared to 39/40 (9 7.5%) in the control group (P < 0.001). AREDFV was associated with a higher rate of chronic lung disease, retinopathy of prematurity greater than or e qual to grade III and impaired intestinal motility. More AREDFV infants suf fered from permanent neurological sequelae compared with control infants: 4 4% versus 25% were mentally retarded (P = 0.033), and 38% versus 19% showed severe motor impairment (P = 0.073). Conclusion Absent or reversed end-diastolic flow velocity is not only assoc iated with a higher mortality and morbidity during the neonatal period, but the surviving infants of this high risk group have an increased risk for m ental retardation and severe motor impairment as compared with appropriate for gestational age preterm infants of the same gestational age.