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Intracranial ultrasound abnormalities and mortality in preterm infants with and without fetal growth restriction stratified by fetal Doppler study results

Journal of Perinatology volume 43, pages 560–567 (2023)Cite this article

Subjects

Abstract

Objective

To evaluate whether fetal growth restriction (FGR) with or without abnormal Dopplers is associated with intracranial abnormalities and death in premature infants.

Study design

Premature infants with and without FGR born between 2016 and 2019 were included. Primary outcome was death, severe intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL). Groups were compared using standard bivariate testing and multivariable regression.

Results

Among 168 FGR and 560 non-FGR infants, FGR infants with abnormal Dopplers had an increased incidence of death, severe IVH or PVL compared to non-FGR infants (13% (16/123) vs. 7% (41/560); p = 0.03) while FGR infants with normal Dopplers had a nonsignificant decrease. In a logistic regression model, FGR with abnormal Dopplers was associated with more than three times higher odds of death, severe IVH or PVL (OR 3.2, 95% CI 1.54,6.49; p < 0.001).

Conclusions

Growth-restricted infants with abnormal Dopplers had an increased risk of death, intracranial abnormalities, and prematurity-related morbidities.

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Fig. 1: Percent of study infants with composite outcome by FGR status.
Fig. 2: Expected length of stay for survivors by growth status across gestational age.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Kiyoko Ohira-Kist for her time and effort in collecting and inputting our institution’s data into the Vermont Oxford Network Database. We would like to thank Cynthia Masson for managing the REDCap maternal and neonatal database as part of the Obstetrics and Gynecology Department at Columbia University Irving Medical Center.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, USA

    Faith Kim, David A. Bateman & Nimrod Goldshtrom

  2. Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, New York, NY, USA

    Jean-Ju Sheen

  3. Division of Neonatology, Department of Pediatrics, Creighton University School of Medicine, Phoenix Regional Campus, Phoenix, AZ, USA

    Donna Garey

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Contributions

FK and DG conceptualized and designed the study, designed the data collection instruments, collected data and drafted the initial manuscript and reviewed and revised the manuscript. DB and NG carried out secondary analyses and reviewed and revised the manuscript. JS reviewed and revised the manuscript. All authors approved the final manuscript and agree to be accountable for all aspects of the work.

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Correspondence to Faith Kim.

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Kim, F., Bateman, D.A., Goldshtrom, N. et al. Intracranial ultrasound abnormalities and mortality in preterm infants with and without fetal growth restriction stratified by fetal Doppler study results. J Perinatol 43, 560–567 (2023). https://doi.org/10.1038/s41372-023-01621-8

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