745 Cross-sectional analysis of mid-trimester maternal uterine artery blood flow, maternal pre-eclampsia and childhood neurodevelopmental outcomes

Abstract

Resistance to blood flow in the maternal uterine artery (UtA) has been associated with both pre-eclampsia and fetal growth restriction. Our objective was to assess the association between increases in mid-trimester maternal UtA Pulsitility Index (PI), pre-eclampsia and child neurodevelopmental outcomes in low-risk pregnancies. Serial ultrasound exams were prospectively performed in 2,334 racially/ethnically diverse, healthy women with low-risk singleton pregnancies (July 2009-Jan 2013) as part of the NICHD- Fetal Growth Studies (NICHD-FGS). Maternal UtA PI measures were obtained between 18w0d and 25w6d. Maternal outcomes were collected at delivery. Mother-child pairs from the NICHD-FGS were re-recruited to the Environmental Influences on Child Health Outcomes (ECHO) Study (May 2017-April 2019). Cross-sectional analysis of ND was performed using the NIH Toolbox for children aged 3-7 and 8-11years. Executive function domains included Inhibitory Control/Attention, Cognitive Flexibility and Working Memory. Motor domains included Dexterity, Grip Strength and Standing Balance. Multivariable adjusted general linear and logistic regression models were used to assess continuous and dichotomous variables. The study group is described in Table 1. A 1-unit increase in the mid-trimester UtA PI was significantly associated with reduced Cognitive Flexibility in children aged 3-7 and improved Inhibitory Control/Attention in children 8-11. For each of these executive domains the results were in opposite directions for children 3-7 and 8-11 years, respectively (Table 2). Incremental change in UtA PI had no impact on any measure of motor function. A 1-unit increase in UtA PI was significantly associated with an increased risk of pre-eclampsia. A 1-unit increase in mid-trimester UtA PI was associated with maternal pre-eclampsia and childhood executive function. Executive effects are variable and different in younger compared to older children. Cognitive Flexibility at 3-7 years and Inhibitory Control/Attention at 8-11 years were negatively and positively influenced, respectively.View Large Image Figure ViewerDownload Hi-res image Download (PPT)