Department of Obstetrics and Gynecology, Medical School University Zagreb, Zagreb, Croatia.
J Perinat Med. 2013 Jan;41(1):107-14. doi: 10.1515/jpm-2012-0018.
The primary aim of this study was to compare circulatory changes in the fetal brain under certain pathological conditions with alterations in fetal behavior.
A prospective longitudinal cohort study on fetal behavior of fetuses from singleton pregnancies between the 28th and 38th gestational week in the period from March 2009 to October 2011 was undertaken. There were 596 fetuses in the high-risk group and 273 fetuses in the low-risk group. Elevated umbilical artery Doppler pulsatility index and reduced middle cerebral artery pulsatility index obtained in the absence of fetal movements were considered abnormal. The Kurjak Antenatal Neurodevelopmental Test (KANET) was used to assess fetal behavior.
Statistically significant differences in the distribution of normal, abnormal, and borderline KANET scores between low-risk and high-risk groups were found. Furthermore, 596 fetuses from the high-risk group were subdivided into subgroups according to the risk factor. The largest proportion of abnormal KANET scores (23.9%) was in the subgroup of fetuses whose mothers had an offspring diagnosed with cerebral palsy (23.9%), followed by the proportion of borderline KANET scores in the subgroup of fetuses from febrile mothers (12.7%). Fetal behavior was significantly different between the normal group and the following subgroups of fetuses: fetal growth restriction (FGR), gestational diabetes mellitus, threatened preterm birth, antepartal hemorrhage, maternal fever, sibling with cerebral palsy, and polyhydramnios.
A new clinical application of the KANET test in early identification of fetuses at risk for adverse neurological outcome was demonstrated.
本研究的主要目的是比较某些病理情况下胎儿大脑的循环变化与胎儿行为的变化。
对 2009 年 3 月至 2011 年 10 月期间 28 至 38 孕周单胎妊娠胎儿的胎儿行为进行前瞻性纵向队列研究。高危组有 596 例胎儿，低危组有 273 例胎儿。在没有胎儿运动的情况下，脐动脉多普勒搏动指数升高和大脑中动脉搏动指数降低被认为是异常的。采用 Kurjak 产前神经发育测试（KANET）评估胎儿行为。
低危组和高危组之间正常、异常和边界 KANET 评分的分布存在统计学显著差异。此外，高危组的 596 例胎儿根据危险因素进一步分为亚组。异常 KANET 评分比例最大（23.9%）的亚组是母亲所生的脑瘫患儿（23.9%），其次是母亲发热的胎儿亚组的边界 KANET 评分比例（12.7%）。正常组与以下胎儿亚组之间的胎儿行为存在显著差异：胎儿生长受限（FGR）、妊娠期糖尿病、早产威胁、产前出血、母亲发热、脑瘫同胞和羊水过多。
KANET 试验在早期识别有不良神经结局风险的胎儿方面有新的临床应用。
