Intrauterine blood flow and long-term intellectual, neurologic, and social development

Wienerroither, Heinrich; Steiner, H.; Tomaselli, Johanna; Lobendanz, Markus; Thun‐Hohenstein, Leonhard

doi:10.1016/s0029-7844(00)01158-3

Cited by 53 publications

(28 citation statements)

References 19 publications

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“…Severely reduced blood flow to the fetus associated with growth retardation may be followed by impairment of intellectual development and partial neurodevelopment delay. 39 Reduced supply of DHA and AA may explain some of the neurologic impairment. Children who are born small for gestational age have smaller head circumference than children who are born appropriate for gestational age, even at 13 months of age.…”

Section: Discussionmentioning

confidence: 99%

Maternal Supplementation With Very-Long-Chain n-3 Fatty Acids During Pregnancy and Lactation Augments Children’s IQ at 4 Years of Age

et al. 2003

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ABSTRACT. Objectives. Docosahexaenoic acid (DHA; 22:6 n-3) and arachidonic acid (AA; 20:4 n-6) are important for development of the central nervous system in mammals. There is a growth spurt in the human brain during the last trimester of pregnancy and the first postnatal months, with a large increase in the cerebral content of AA and DHA. The fetus and the newborn infant depend on maternal supply of DHA and AA. Our hypothesis was that maternal intake of DHA during pregnancy and lactation is marginal and that high intake of this fatty acid would benefit the child. We examined the effect of supplementing pregnant and lactating women with very-long-chain n-3 polyunsaturated fatty acids (PUFAs; cod liver oil) on mental development of the children, compared with maternal supplementation with long-chain n-6 PUFAs (corn oil).Methods. The study was randomized and doubleblinded. Pregnant women were recruited in week 18 of pregnancy to take 10 mL of cod liver oil or corn oil until 3 months after delivery. The cod liver oil contained 1183 mg/10 mL DHA, 803 mg/10 mL eicosapentaenoic acid (20:5 n-3), and a total of 2494 mg/10 mL ͚ n-3 PUFAs. The corn oil contained 4747 mg/10 mL linoleic acid (18:2 n-6) and 92 mg/10 mL ␣-linolenic acid (18:3 n-3). The amount of fat-soluble vitamins was identical in the 2 oils (117 g/mL vitamin A, 1 g/mL vitamin D, and 1.4 mg/mL dl-␣-tocopherol). A total of 590 pregnant women were recruited to the study, and 341 mothers took part in the study until giving birth. All infants of these women were scheduled for assessment of cognitive function at 6 and 9 months of age, and 262 complied with the request. As part of the protocol, 135 subjects from this population were invited for intelligence testing with the Kaufman Assessment Battery for Children (K-ABC) at 4 years of age. Of the 135 invited children, 90 came for assessment. Six children did not complete the examination. The K-ABC is a measure of intelligence and achievement designed for children aged 2.5 years through 12.5 years. This multisubtest battery comprises 4 scales: Sequential Processing, Simultaneous Processing, Achievement (not used in the present study), and Nonverbal Abilities. The Sequential Processing and Simultaneous Processing scales are hypothesized to reflect the child's style of problem solving and information processing. Scores from these 2 scales are combined to form a Mental Processing Composite, which serves as the measure of intelligence in the K-ABC.Results. We received dietary information from 76 infants (41 in the cod liver oil group and 35 in the corn oil group), documenting that all of them were breastfed at 3 months of age. Children who were born to mothers who had taken cod liver oil (n ‫؍‬ 48) during pregnancy and lactation scored higher on the Mental Processing Composite of the K-ABC at 4 years of age as compared with children whose mothers had taken corn oil (n ‫؍‬ 36; 106. D ocosahexaenoic acid (DHA; 22:6 n-3) and arachidonic acid (AA; 20:4 n-6) are important for development of the central nervous system in ma...

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Section: Discussionmentioning

confidence: 99%

Maternal Supplementation With Very-Long-Chain n-3 Fatty Acids During Pregnancy and Lactation Augments Children’s IQ at 4 Years of Age

et al. 2003

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“…The earlier an IUGR is diagnosed during pregnancy, the graver is the prognosis for the fetus or infant 2 . The combination of extreme prematurity and small for gestational age birthweight carries a high risk of long term serious sequelae 7,8 . The focus of the current study is to address the association between mid-trimester severe IUGR and the presence of maternal thrombophilia.…”

Section: Introductionmentioning

confidence: 99%

Mid-trimester severe intrauterine growth restriction is associated with a high prevalence of thrombophilia

Kupferminc

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To investigate the association between severe mid-trimester IUGR, whose causes are unknown in most cases, and maternal thrombophilias. Design Case -control study.Setting Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University. Population Twenty-six women with severe mid-trimester (22 -26 weeks of gestation) IUGR (birthweight <3rd centile) and 52 matched multiparous women with normal pregnancies (controls).Methods After excluding pregnancies with vascular maternal disease, chromosomal and structural aberrations and cytomegalovirus infection, 26 women out of 35 with severe mid-trimester IUGR remained and composed the study group. Each was matched for age, ethnicity and smoking status with two healthy women who had normal pregnancies. All the women were tested for genetic and acquired thrombophilias at least eight weeks after delivery. Main outcome measures Prevalence of maternal thrombophilias.Results The frequency of thrombophilias was 69% in the study group compared with 14% in the control group [odds ratio (OR) 4.5; 95% confidence interval (CI) 2.3-9, P < 0.001]. The frequencies of factor V Leiden mutation, prothrombin gene mutation and protein S deficiency were significantly increased in the study group compared with the control group. The frequency of multiple thrombophilias was 33% in the study group versus none among the controls. Of the 26 pregnancies with severe mid-trimester IUGR, 13 ended in intrauterine fetal death before 25 weeks of gestation: 10 of these women had thrombophilia. Conclusion Women with mid-trimester severe IUGR have an increased prevalence of inherited and acquired thrombophilias.

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“…Compared to gestational-age matched peers, those with IUGR are at higher risk of morbidity and mortality (Damodaram et al 2011), particularly if growth restriction is severe (Vossbeck et al 2001, Wienerroither et al 2001 and delivery is very preterm (Bernstein et al 2000). The fetus chronically deprived of oxygen and substrates is at increased risk of stillbirth, fetal distress, congenital malformation, meconium aspiration, cord compression, premature rupture of membranes and preterm birth.…”

Section: Pathophysiologymentioning

confidence: 99%

Recent Advances in Neonatal Gastroenterology and Neonatal Nutrition

Rao¹,

Ravikumara²,

Simmer³

2012

Neonatal Care

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Intrauterine blood flow and long-term intellectual, neurologic, and social development

Abstract: Severely reduced blood flow to the fetus associated with growth restriction was followed by long-term impairment of intellectual development and partial neurodevelopmental delay.

Cited by 53 publications

References 19 publications

Maternal Supplementation With Very-Long-Chain n-3 Fatty Acids During Pregnancy and Lactation Augments Children’s IQ at 4 Years of Age

Maternal Supplementation With Very-Long-Chain n-3 Fatty Acids During Pregnancy and Lactation Augments Children’s IQ at 4 Years of Age

Mid-trimester severe intrauterine growth restriction is associated with a high prevalence of thrombophilia

Recent Advances in Neonatal Gastroenterology and Neonatal Nutrition

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