Cardiovascular programming in children born small for gestational age and relationship with prenatal signs of severity
Cardiovascular programming in children born small for gestational age and relationship with prenatal signs of severity
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DOI：
10.1016/j.ajog.2012.05.011
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发表时间：
2012-08-01
影响因子：
9.8
通讯作者：
Gratacos, Eduard
中科院分区：
文献类型：
--
作者：
Crispi, Fatima;Figueras, Francesc;Gratacos, Eduard
目的：这项研究的目的是评估儿童的心血管功能谁是小于胎龄（SGA）fetals.Study设计：这是一项前瞻性研究，包括100名对照组和50名儿童在子宫内诊断为SGA后34周细分为以下类别：SGA和胎儿宫内生长受限（IUGR）分别根据是否存在体重百分位数小于3或异常胎盘多普勒来判断。出生后的心血管结果进行了评价，在3-6岁的超声心动图，血压，和颈动脉ultrason.RESULTS：SGA和IUGR在儿童更多的球形心脏，减少纵向运动，和受损的放松与增加的径向功能。两组均显示血压和颈动脉内膜中层厚度增加。IUGR的心血管结果与SGA相比呈线性恶化趋势。结论：无论多普勒和体重百分位数如何，SGA均存在胎儿心血管程控。这些发现挑战了体质小的概念，需要进一步研究以确定SGA心血管结局的预测因子。
OBJECTIVE: The objective of the study was to evaluate cardiovascular function in children who were small-for-gestational-age (SGA) fetuses.STUDY DESIGN: This was a prospective study including 100 controls and 50 children diagnosed in utero as SGA after 34 weeks subdivided into the following categories: SGA and intrauterine growth restriction (IUGR) according to the absence or presence, respectively, of weight centile less than 3 or abnormal cerebroplacental Doppler. Postnatal cardiovascular outcome was evaluated at 3-6 years of age by echocardiography, blood pressure, and carotid ultrasound.RESULTS: Both SGA and IUGR presented in childhood more globular hearts, reduced longitudinal motion, and impaired relaxation with an in-crease in radial function. Both groups showed increased blood pressure and carotid intima-media thickness. There was a linear tendency to worse cardiovascular results in IUGR as compared with SGA.CONCLUSION: Fetal cardiovascular programming occurs in SGA, regardless of Doppler and weight centile. These findings challenge the concept of constitutionally small and warrant further investigation to identify predictors of cardiovascular outcome in SGA.