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
{"title":"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。","authors":"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","doi":"10.1080/02646838.2024.2409145","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims/background: </strong>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.</p><p><strong>Design/methods: </strong>Dutch mothers with a low-risk pregnancy participating in a subsample (<i>n</i> = 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 (<i>n</i> = 380) comprised selective ultrasonography. The intervention strategy (<i>n</i> = 690) included two routine third-trimester ultrasounds next to usual care. Both strategies applied the same interdisciplinary protocol for FGR detection and management.</p><p><strong>Results: </strong>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], <i>p</i> = 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":47721,"journal":{"name":"Journal of Reproductive and Infant Psychology","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Routine third-trimester ultrasonography and child neurodevelopmental outcomes: a follow-up of a pragmatic cluster-randomised controlled trial.\",\"authors\":\"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\",\"doi\":\"10.1080/02646838.2024.2409145\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims/background: </strong>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.</p><p><strong>Design/methods: </strong>Dutch mothers with a low-risk pregnancy participating in a subsample (<i>n</i> = 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 (<i>n</i> = 380) comprised selective ultrasonography. The intervention strategy (<i>n</i> = 690) included two routine third-trimester ultrasounds next to usual care. Both strategies applied the same interdisciplinary protocol for FGR detection and management.</p><p><strong>Results: </strong>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], <i>p</i> = 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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":47721,\"journal\":{\"name\":\"Journal of Reproductive and Infant Psychology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-10-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Reproductive and Infant Psychology\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1080/02646838.2024.2409145\",\"RegionNum\":4,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHOLOGY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Reproductive and Infant Psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1080/02646838.2024.2409145","RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHOLOGY, MULTIDISCIPLINARY","Score":null,"Total":0}
Routine third-trimester ultrasonography and child neurodevelopmental outcomes: a follow-up of a pragmatic cluster-randomised controlled trial.
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.
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.
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