Integrating KANET and Doppler indices to predict neurodevelopmental delays in high-risk pregnancies

OBJECTIVES: To assess the predictive value of combining the Kurjak Antenatal Neurodevelopmental Test (KANET) with Doppler indices for early detection of neurodevelopmental delays in pregnancies of varying risk levels. METHODS: A prospective study was conducted on 111 pregnant women (71 low-risk, 40 high-risk) between 28 and 36 weeks of gestation. KANET was performed using 4D ultrasound. Doppler assessments included resistance indices of the middle cerebral artery (MCA) and umbilical artery (UA), and ductus venosus (DV) velocity parameters: systolic (S), diastolic (D), and S/D ratio. High-risk cases with abnormal findings underwent repeat KANET. Postnatal neurodevelopment was evaluated at 3 and 6 months using the Denver Developmental Screening Test II (DDST II). Statistical analyses included regression and ROC curve analysis. RESULTS: High-risk pregnancies showed significantly lower KANET scores (mean 13.4 ± 2.3) than low-risk pregnancies (mean 16.9 ± 1.5; p<0.001). Abnormal DV Doppler findings were present in 42 % of high-risk cases and correlated with lower KANET scores (r=0.82, p<0.01). Follow-up KANET identified progressive neurodevelopmental delays in 25 % of high-risk cases. The combined KANET-Doppler approach demonstrated superior predictive accuracy (AUC=0.89, p<0.001) compared to either method alone. CONCLUSIONS: Integrating KANET with Doppler indices, particularly DV parameters, offers an effective strategy for early identification of neurodevelopmental risks in high-risk pregnancies. This approach supports more targeted prenatal monitoring and early intervention strategies.