Background Although doppler resistance index (RI) has some predictive value in asphyxiated term newborns, little is known of the long term predictive value of this measure for outcome in preterm infants admitted to neonatal intensive care (NICU).

Subjects Tertiary NICU. 2.8 year study period. Studied all infants who were ≤32 weeks gestation or >32 weeks and ventilated for more than 4 hours or asphyxiated.

Intrvention Daily measure of RI of anterior cerebral artery for first 7 days of life. Developmental follow up of infants at 1-4 years by hospital based Denver Developmental assessment or by community based developmental screening; assessed as normal(N), suspicious (S), abnormal(A) or dead(D).

Results 600 infants studied. Follow up in 93%. No significant RI trend over 7 days in any group. Poor outcome significantly associated with a high maximum RI in gp 2 (p<0.0001) and low minimum RI in gp 3 (p<0.05) and gp 4 (p<0.0001). Association remained even after excluding infants who died. 11 of 12 infants (10 in gp 4) with a min RI ≤0.43 died (12th severely handicapped). RI≤0.55 in 73 infants (47% <37 weeks); poor outcome in 49%, independent of gestation. No clear upper limit determined for RI and poor outcome in gp 2. Table

Table 1
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Conclusion RI ≤0.43 associated with extremely poor outcome at any gestation, but particularly use at term. RI≤0.55 had poor outcome in 49% of infants, both term and breterm.