Persistence of umbilical artery Doppler abnormalities following antenatal corticosteroids: association with perinatal outcome and neurodevelopmental disability at two years of age.

Background: Administration of antenatal corticosteroids in pregnancies with absent or reversed end-diastolic flow (A/REDF) on umbilical artery Doppler results in transient improvement in flow in two-thirds of pregnancies. It has been hypothesized that persistent abnormalities may be associated with poorer perinatal outcomes. Aim: To determine whether umbilical artery doppler unresponsiveness to antenatal steroids in growth restricted fetuses is predictive of perinatal outcomes in babies born preterm. Methods: Retrospective cohort study of singleton pregnancies with umbilical artery A/REDF, who had Dopplers performed before and after steroids. Outcomes were compared in pregnancies with and without a response. Cases were identified from ultrasound records and maternity, neonatal and follow-up records reviewed. Outcomes included gestation at delivery, birth weight, perinatal mortality and significant neonatal morbidity (bronchopulmonary dysplasia, intracranial haemorrhage, necrotizing enterocolitis and retinopathy of prematurity) and neurodevelopmental disability at 2 years corrected age.. Data were analyzed with Chi-square.Results: 46 pregnancies were eligible for inclusion and two year paediatric follow-up data available for 28 babies