Original Articles
Routine Ultrasound Screening in Pregnancy and the Children’s Subsequent Neurologic Development 1

https://doi.org/10.1016/S0029-7844(98)00062-3Get rights and content

Abstract

Objective: To test the null hypothesis of no association between ultrasound exposure in early fetal life and impaired neurologic development in childhood.

Methods: Study of children age 8–9 years whose mothers participated in a randomized controlled trial of ultrasound screening during pregnancy in Sweden during 1985–1987. Of 4637 eligible singletons, 3265 (70%) were studied through a questionnaire to their mothers. Assessment of neurologic development was based on parents’ report of their child’s speech and motor development. Behavioral disorders were assessed by a ten-item parent scale. Analyses were performed according to both assignment and ultrasound exposure. With a sample size of 1600 children in each group, a two-sided α of .05 and β of .10, a risk ratio of less than 1.4 for the studied variables could not be detected.

Results: Delayed speech development was reported by 2.9% in the screening group compared with 2.4% in the nonscreening group (odds ratio [OR] 1.21; 95% confidence interval [CI] 0.79, 1.88). Similar prevalences were found when analysis was according to ultrasound exposure (OR 1.19, 95% CI 0.78, 1.83). Delayed motor development was reported by 7.6% in the screening group compared with 7.2% in the nonscreening group (OR 1.05; 95% CI 0.81, 1.37). Corresponding figures for ultrasound-exposed and -unexposed were 7.7% and 7.2%, respectively (OR 1.08; 95% CI 0.83, 1.40). There also were no significant differences in behavioral disorders between screened and unscreened children or between exposed and unexposed children, respectively, according to parents’ ratings.

Conclusion: No significant difference in impaired neurologic development between ultrasound-exposed and -unexposed children was found in this study.

Section snippets

Methods

We conducted two studies, a randomized controlled trial during 1985–1987, and a follow-up study during 1995. The Ethical Committee of the Medical Faculty of Uppsala University approved both studies.

Results

In the screening group, 661 mothers did not respond or declined participation, leaving 1651 (71.4%) of 2312 screened children in the follow-up study. In the unscreened group, 711 did not respond or declined participation, leaving 1614 (69.4%) of 2325 children (Fig. 1). Before 19 weeks’ gestation, 1704 children were exposed to ultrasound and 1561 were not.

The responders were older than nonresponders (27.7 versus 27.0 years) and less often were smokers (26% versus 33%) compared with the

Discussion

No statistically significant differences in speech and motor development or behavioral disorders between children 8–9 years of age who had been exposed to ultrasound in early fetal life and unexposed children were found in this study, in agreement with the findings of Salvesen et al.10, 12The prevalences of delayed speech and motor development were slightly higher among scanned children than among unscanned children. An association between ultrasound and delayed speech was found in a previous

References (28)

  • MA Dinno et al.

    The significance of membrane changes in the safe and effective use of therapeutic and diagnostic ultrasound

    Phys Med Biol

    (1989)
  • EA Reece et al.

    The safety of obstetric ultrasonographyConcern for the fetus

    Obstet Gynecol

    (1990)
  • CR Stark et al.

    Short- and long-term risks after exposure to diagnostic ultrasound in utero

    Obstet Gynecol

    (1984)
  • JD Campbell et al.

    Case-control study of prenatal ultrasonography exposure in children with delayed speech

    Can Med Assoc J

    (1993)
  • Cited by (34)

    • First-Trimester Fetal Echocardiography: Identification of Cardiac Structures for Screening from 6 to 13 Weeks’ Gestational Age

      2017, Journal of the American Society of Echocardiography
      Citation Excerpt :

      To date, documented harmful effects of fetal ultrasound have been limited to animal data.36-38 Such findings have not been evident in human studies correlating fetal ultrasound exposure with childhood neurologic and developmental outcomes.39-44 A consensus from the International Society of Ultrasound in Obstetrics and Gynecology published in 2011 concluded that color Doppler should not be used routinely in the first trimester but should be reserved for certain clinical indications, for which a cardiac examination is an example.

    • Evaluation of the prenatally diagnosed mass

      2012, Seminars in Fetal and Neonatal Medicine
      Citation Excerpt :

      This ability to detect fetal anomalies is also coupled with the relative safety of fetal ultrasound. To date, there has been no study that demonstrates any significant deleterious effect of ultrasound on the fetus.6 Long term follow-up on children exposed to fetal ultrasound also did not demonstrate any significant difference in overall school performance as these children became teenagers.7

    • Exposure to ultrasound in utero: Epidemiology and relevance of neuronal migration studies

      2010, Ultrasound in Medicine and Biology
      Citation Excerpt :

      In 1990s, results were published of two large follow-up studies of 7–9-year-old children born to women who participated in the randomized controlled studies of routine ultrasound in pregnancy in Norway and Sweden, respectively. These studies did not find any evidence of possible negative effects of exposure to diagnostic ultrasound in utero on postnatal neurological development (Kieler et al. 1998a; Salvesen et al. 1993a,b), vision and hearing (Salvesen et al. 1992a; Kieler et al. 1997), speech development (Salvesen et al. 1994), motor control, perception and school performance (Salvesen et al. 1992b). However, a possible association between ultrasound and nonright-handedness in boys was found as summarized in a meta-analysis of the two Scandinavian studies (Salvesen and Eik-Nes 1999).

    • Epidemiological prenatal ultrasound studies

      2007, Progress in Biophysics and Molecular Biology
    View all citing articles on Scopus
    1

    Financial support was provided by The Research Council of Dalarna; the Foundation of Astrid Karlsson, Uppsala University; and the Foundation of Medical Research and Evaluation in Dalarna in cooperation with Uppsala University.

    View full text