Early neurobehavioral outcome in preterm small for gestational age neonates with increased pulsatility index in antenatal umbilical artery Doppler.

Objective: To evaluate the early neurobehavioral outcome in preterm small for gestational age neonates with increased pulsatility index in antenatal umbilical artery Doppler.Method: A prospective cohort study was conducted at a tertiary care neonatal unit in India. 30 preterm SGA neonates born to mothers with increased pulsatility index (> 95th centile) were enrolled and compared with 30 SGA neonates with normal pulsatility index (<95th centile). These neonates were followed up to 40 weeks of post-menstrual age. They were evaluated by NAPI score of MDV (Motor development-vigor) and AO (Alertness orientation) at 40 weeks.Result: The mean NAPI score of MDV (Motor development- vigor) in neonates born to mothers with pulsatility index ≥95th percentile in umbilical artery Doppler was 58.59 ± 11.28 as compared to 61.73 ± 10.24 in another group (p-value 0.263) and mean difference (95%CI) was 3.14(2.42-8.71). The mean NAPI score of AO (Alertness-orientation) in the exposed group was 54.47 ± 10.19 as compared to 56.36 ± 9.07 in the unexposed group (p-value 0.44) and mean difference (95%CI) was 1.89 (3.1-6.88).Conclusion: Preterm, SGA neonates born to mothers with high pulsatility index in umbilical artery Doppler had low neurodevelopmental scores as compared to neonates with normal PI.