Routine third-trimester ultrasonography and child neurodevelopmental outcomes: a follow-up of a pragmatic cluster-randomised controlled trial.

IF 2.1 4区心理学 Q2 PSYCHOLOGY, MULTIDISCIPLINARY

Journal of Reproductive and Infant Psychology Pub Date : 2024-10-02 DOI:10.1080/02646838.2024.2409145

Jens Henrichs, Marielle van Roekel, Anke B Witteveen, Michael Veder, Yoni Feenstra, Arie Franx, Marlou L A de Kroon, Anneloes van Baar, Corine J Verhoeven, Ank de Jonge

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引用次数: 0

Abstract

Aims/background: Routine third-trimester ultrasonography is increasingly conducted to screen for foetal growth restriction (FGR) and reduce adverse perinatal and child neurodevelopmental outcomes using timely obstetric management. While it did not reduce adverse perinatal outcomes in previous trials, evidence regarding its association with child neurodevelopmental outcome is absent. We examined whether routine third-trimester ultrasonography is positively associated with child developmental and behavioural/emotional outcomes compared to usual care.

Design/methods: Dutch mothers with a low-risk pregnancy participating in a subsample (n = 1070) of a nationwide cluster-randomised trial reported infant (age 6 months) and toddler (age 28 months) developmental milestones (Ages and Stages Questionnaire) and toddlers' internalising and externalising problems (Child Behavior Checklist). Usual care (n = 380) comprised selective ultrasonography. The intervention strategy (n = 690) included two routine third-trimester ultrasounds next to usual care. Both strategies applied the same interdisciplinary protocol for FGR detection and management.

Results: Adjusted linear mixed-level regressions revealed that routine third-trimester ultrasonography was positively but modestly related to z-standardised infant developmental milestones at 6-month follow-up, B = 0.20, 95%CI [0.07; 0.32], p = 0.003, compared to usual care. At 28-month follow-up, these strategies did not differ in child developmental outcome and internalising and externalising problems.

Conclusion: Routine third-trimester ultrasonography was positively but modestly associated with infant development. In toddlerhood, routine ultrasonography was not related to child developmental and behavioural/emotional outcomes. Overall, these findings do not support the implementation of routine third-trimester ultrasonography for low-risk pregnant women for reasons concerning children's early neurodevelopmental outcomes.

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常规第三孕期超声波检查和儿童神经发育结果：实用分组随机对照试验的后续研究。

目的/背景：常规第三孕期超声检查越来越多地用于筛查胎儿生长受限（FGR），并通过及时的产科管理减少围产期和儿童神经发育的不良后果。虽然在以往的试验中，超声检查并未减少围产期不良结局，但却缺乏有关超声检查与儿童神经发育结局相关性的证据。我们研究了与常规护理相比，常规第三孕期超声波检查是否与儿童发育和行为/情感结局呈正相关：荷兰低风险妊娠母亲参与了一项全国性群组随机试验的子样本（n = 1070），并报告了婴儿（6 个月大）和幼儿（28 个月大）的发育里程碑（年龄与阶段问卷）以及幼儿的内化和外化问题（儿童行为检查表）。常规护理（n = 380）包括选择性超声波检查。干预策略（n = 690）除了常规护理外，还包括两次第三胎常规超声波检查。两种策略均采用相同的跨学科方案进行FGR检测和管理：调整后的线性混合水平回归显示，与常规护理相比，常规第三孕期超声波检查与6个月随访时婴儿发育里程碑的z标准化呈正相关，但关系不大，B=0.20，95%CI [0.07; 0.32]，P=0.003。在28个月的随访中，这些策略在儿童发育结果、内化和外化问题方面没有差异：结论：常规第三孕期超声波检查与婴儿发育呈正相关，但关系不大。在幼儿期，常规超声波检查与儿童发育和行为/情绪结果无关。总体而言，这些研究结果并不支持出于对儿童早期神经发育结果的考虑，对低风险孕妇实施常规第三孕期超声波检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Reproductive and Infant Psychology PSYCHOLOGY, MULTIDISCIPLINARY-

CiteScore

6.80

自引率

8.00%

发文量

期刊介绍： The Journal of Reproductive and Infant Psychology reports and reviews outstanding research on psychological, behavioural, medical and social aspects of human reproduction, pregnancy and infancy. Medical topics focus on obstetrics and gynaecology, paediatrics and psychiatry. The growing work in relevant aspects of medical communication and medical sociology are also covered. Relevant psychological work includes developmental psychology, clinical psychology, social psychology, behavioural medicine, psychology of women and health psychology. Research into psychological aspects of midwifery, health visiting and nursing is central to the interests of the Journal. The Journal is of special value to those concerned with interdisciplinary issues. As a result, the Journal is of particular interest to those concerned with fundamental processes in behaviour and to issues of health promotion and service organization.