Fetal blood flow redistribution in term intrauterine growth retardation (IUGR) and post-natal growth.

OBJECTIVE

The purpose of the present study was to evaluate the relationship between intrauterine growth retardation, represented by fetal blood flow redistribution and infantile growth.

METHODS

The blood flow velocity waveform of umbilical and middle cerebral arteries was recorded by Doppler ultrasonography in 77 growth-retarded fetuses. We recorded the pulsatility index (PI) of the umbilical artery and middle cerebral and calculated the PI ratio of the middle cerebral to umbilical artery (C/U ratio). We selected a cutoff value of 1.0 to distinguish between normal and abnormal C/U ratios. To evaluate the development of infants, height, body weight and head circumference were measured serially at 3, 6 and 12 months of age.

RESULTS

Birth weight was significantly lower in newborns who had abnormal C/U ratios (2021+/-295 g vs. 2294+/-236 g). The number of cases admitted to NICU was higher and the duration of admission was longer in abnormal C/U ratio group (15/29 and 33.7+/-13.5 days) than normal C/U ratio group (7/48 and 26.6+/-5.6 days). Body weight was lower in infants of abnormal C/U ratio group at 3 months, but was not different at 6 and 12 months. The height was shorter in abnormal C/U ratio group at birth, there were no significant differences at 3, 6 and 12 months. The number of newborn infants with growth retardation was slightly higher in abnormal C/U ratio group, but the difference was not significant at 6 and 12 months. There was no relationship between C/U and growth variables recorded at birth and follow-up in infants.

CONCLUSION

Intrauterine growth-retardation, represented by abnormal fetal blood redistribution was associated with adverse perinatal outcome, but the influence was not found at the first year of life.