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A prospective cohort study was conducted to determine whether an increased uterine artery pulsatility index (UtA-PI) in the second trimester of pregnancy is a risk factor for neurodevelopmental outcomes in children 2-3 years of age. A group of pregnant women with a UtA-PI below the 90th percentile (P90) and a second group with a UtA-PI ≥ P90 in the second trimester were included in this study. The children of these women were evaluated during their second or third year of life using the Bayley III Screening Test. A total of 858 pregnancies with UtA-PI < P90 and 96 pregnancies with UtA-PI ≥ 90 were studied. The differences between the groups related to UtA-PI ≥ 90 were detected in relation to the variables of the Caucasian ethnicity, hypertension, newborn weight and stay in the intensive care unit after birth. However, adjusted neurodevelopmental outcomes did not differ between the groups: OR 0.53 (95% CI 0.27-1.04%). This study failed to demonstrate that the UtA-PI is a risk factor for adverse neurodevelopment in children.Impact statementWhat is already known on this subject? Early interventions in children at high risk for neurodevelopmental deficiency have proved to be beneficial. The complications associated with gestation and delivery negatively influence neurodevelopment. Several studies have shown that some adverse pregnancy outcomes such as preeclampsia, foetal growth restriction and foetal death can be predicted by increased resistance to flow in the uterine artery in the second trimester. However, there are no studies evaluating the association of the uterine artery with neurodevelopmental results.What do the results of this study add? This study concludes that neurodevelopment is influenced by multiple environmental and intrinsic factors and cannot be predicted by only one variable, such as the uterine artery blood flow. The brain has repair mechanisms to attenuate insults that occur during gestation and delivery.What are the implications of these findings for clinical practice and/or further research? This study was unable to demonstrate that blood flow in the uterine artery is a risk factor for neurodevelopment. Different, larger studies should be conducted by combining other factors with the uterine artery in an algorithm to allow the early identification of children at risk for neurodevelopmental impairment.

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BACKGROUND AND OBJECTIVES: Thrombophilia might increase the risk of suffering from obstetric complications by adversely affecting the normal placental vascular function. Our aim was to study the distributions of five thrombosis-associated genetic variants: factor V Leiden, prothrombin G20210A, -675 4G/5G PAI-1, 10034C/T gamma fibrinogen and 7872C/T factor XI and the frequencies of the deficiencies of protein C, S and antithrombin in Argentinian patients with recurrent pregnancy loss (RPL) and, therefore, to analyse their association with the risk and timing of RPL and the risk of suffering other vascular obstetric pathologies. PATIENTS AND METHODS: We performed a case-control study that included 247 patients with idiopathic RPL (cases), 107 fertile controls and 224 subjects from general population (reference group). Cases were stratified according to the gestational time of the losses (early RPL, n = 89; late losses, n = 158; foetal losses, n = 107) and according to the type of vascular obstetric pathologies. RESULTS: No differences were found in the distribution of the genetic variants among RPL group vs. control/reference group (p >.05). Similarly, no differences were observed in their distributions when analysing RPL patients stratified according to gestational times or vascular obstetric pathologies (p >.05), except for the factor V Leiden carriage in patients with foetal growth retardation vs. controls (11.8%, 4/34 vs. 1.9%, 2/107; p = .04) (OR = 7.11 [1.24-40.93], p = .03). CONCLUSIONS: Factor V Leiden might have a significant impact on certain obstetric pathologies such as foetal growth retardation. The genetic variants, 10034C/T gamma fibrinogen and 7872C/T factor XI, associated with thromboembolic disease, would not have an impact on PRE.

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Determinar la prevalencia de restricción del crecimiento intrauterino (RCIU) en el Hospital Universitario San José (HUSJ), describir sus características y hacer una exploración de los factores de riesgo asociados a RCIU. Materiales y métodos: estudio de corte transversal en el que se incluyeron los recién nacidos vivos en un hospital universitario de referencia ubicado en la región suroccidental de Colombia en el año 2013, se excluyeron aquellos con información inconsistente. Se definió recién nacido con restricción del crecimiento intrauterino (RCIU) como el neonato vivo con índice ponderal (Rohrer) menor al percentil 10, IP = [peso (en gramos) x 100] ÷ [longitud (en cm)]3. Para el tamaño de muestra se tuvo en cuenta una prevalencia esperada de RCIU del 4 %, un error tolerado del 2 %, corrección por población finita y por no respuesta del 20 %, obteniendo así un tamaño muestral de 400 sujetos. Se realizó un muestreo aleatorio sistemático. Se utilizó un cuestionario semi-estructurado, que incluyó variables biológicas, sociales y demográficas. Se estimó la prevalencia de periodo de RCIU y se realizó exploración de los factores asociados a RCIU por medio de análisis bi y mutivariado. Se utilizó la prueba t de Student para variables continuas y chi cuadrado para categóricas.Resultados: el análisis se realizó con 392 neonatos; se excluyeron 8, por inconsistencia en la información suministrada; se encontraron 79 neonatos con RCIU para una prevalencia del 20,15 %. En la exploración de los factores de riesgo se encontró una asociación positiva con RCIU y ganancia inadecuada de peso (OR = 2,35; IC 95 %: 1,15-4,82), antecedente de RCIU (OR = 3,26; IC 95 %: 1,08-9,78), amenaza de parto pretérmino (OR = 3,58; IC 95 %: 1,15-11,1), antecedente de cesárea (OR = 2,64; IC 95 %: 1,24- 5,60), y una asociación negativa entre etnia mestiza y raza blanca (OR = 0,25; IC 95 %: 0,07-0,91). Conclusión: la prevalencia encontrada fue del 20,15%, la cual es mayor que la reportada en otras instituciones de este mismo nivel de complejidad...

To determine the prevalence of Intra-uterine Growth Restriction (IUGR) at San Jose University Hospital (HUSJ), describe its characteristics, and explore risk factors associated with IUGR.Materials and methods: Cross-sectional study of live neonates delivered in a referral university hospital located in Southwestern Colombia in 2013. Cases with inconsistent information were excluded. Neonates with intra-uterine growth restriction (IUGR) were defined as live neonates with a ponderal index (Rohrer) below the 10th percentile, PI = [weight (in grams) x 100] ÷ [length (in cm)]3. For the sample size, the following was taken into consideration: expected IUGR prevalence of 4%, 2% tolerated error, finite population correction and 20% non response, resulting in a final sample size of 400 subjects. A systematic random sampling was performed. A semi-structured questionnaire including biological, social and demographic variables was used. The prevalence of the IUGR period was estimated. Factors associated with IUGR were explored using bivariate and multivariate analyses. The Student t test was used for continuous variables and the Chi square test was used for categorical variables.Results: Overall, 392 neonates were included in the analysis, and 8 were excluded because of inconsistent information. There were 79 neonates with IUGR, for a prevalence of 20.15%. When the risk factors were explored, a positive association was found between IUGR and inadequate weight gain (OR = 2.35; 95% CI: 1.15-4.82), history of IUGR (OR = 3.26; 95% CI: 1.08-9.78), threat of preterm delivery (OR = 3.58; 95% CI: 1.15-11.1), and prior C-section (OR = 2.64; 95% CI: 1.24-5.60), and a negative association was found with mestizo ethnic background and white race (OR = 0.25; 95% CI: 0.07-0.91).Conclusion: The prevalence was found to be 20.15%, which is higher than that reported in other institutions of similar complexity level...

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