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Updated: May 23, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Maternal and fetal cord blood lipids in intrauterine growth restriction
Ulrich Pecks1, Meike Brieger, Barbara Schiessl
1Department of Obstetrics and Gynecology of the University Hospital of the RWTH Aachen, Germany. upecks@ukaachen.de
Insights
Intrauterine growth restriction (IUGR) fetuses exhibit disturbed cholesterol metabolism, with lower HDL-C and higher atherogenic indices. This may link IUGR to later cardiovascular disease risk in small for gestational age (SGA) neonates.
Area of Science:
- Perinatal Medicine
- Neonatology
- Cardiovascular Research
Background:
- Small for gestational age (SGA) neonates are categorized as either intrauterine growth restricted (IUGR) or constitutionally small.
- IUGR involves pathological growth restriction and compromised fetal well-being, distinct from genetically small infants.
- Maternal metabolic changes, particularly lipid metabolism, are implicated in IUGR pathogenesis and may impact fetal cardiovascular programming.
Purpose of the Study:
- To investigate fetal serum lipid profiles in IUGR neonates.
- To test the hypothesis that IUGR fetuses have a more atherogenic lipoprotein profile.
- To differentiate lipid profiles between IUGR, constitutionally SGA, and appropriate for gestational age neonates.
Main Methods:
- Umbilical cord serum lipids and oxidized low-density lipoprotein (oxLDL) were measured using enzymatic assays and ELISA.
- Lipid profiles of IUGR (n=36), SGA (n=22), and control neonates (CN, n=97) were compared.
- Statistical analysis involved two-way ANOVA adjusted for gestational age.
Main Results:
- IUGR fetuses showed significantly lower fetal high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) compared to CN and SGA groups.
- Atherogenic indices, such as the oxLDL/LDL-C ratio, were elevated in IUGR fetuses relative to controls.
- These findings indicate a disturbed cholesterol supply and an pro-atherogenic lipid profile in IUGR.
Conclusions:
- The study supports a disturbed cholesterol supply in IUGR fetuses.
- Reduced fetal HDL-C and increased atherogenic indices in IUGR may contribute to the known association between SGA birth and later cardiovascular disease.
- These lipid alterations provide a potential mechanistic link between IUGR and future cardiovascular risks.
Aim:
Small for gestational age neonates (SGA) could be subdivided into two groups according to the underlying causes leading to low birth weight. Intrauterine growth restriction (IUGR) is a pathologic condition with diminished growth velocity and fetal compromised well-being, while non-growth restricted SGA neonates are constitutionally (genetically determined) small. Antenatal sonographic measurements are used to differentiate these two subgroups. Maternal metabolic changes contribute to the pathogenesis of IUGR. A disturbed lipid metabolism and cholesterol supply might affect the fetus, with consequences for fetal programming of cardiovascular diseases. We evaluated fetal serum lipids and hypothesized a more atherogenic lipoprotein profile in IUGR fetuses.
Methods:
Umbilical cord serum lipids and oxidative modified, low-density lipoprotein (oxLDL) concentrations were measured by colorimetric enzymatic measurements, or by ELISA. Values of IUGR (n=36) and constitutionally small for gestational age neonates (SGA, n=22) were compared with those of healthy, adequate for gestational age, born neonates (CN, n=97). SAS-statistic software was used and two-way ANOVA was adjusted for gestational age at delivery.
Results:
Fetal high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) concentrations were found to be lower in the IUGR compared to the CN and SGA groups (HDL-C: P<0.001, TC: P<0.01). Atherogenic indices, including the oxLDL/LDL-C ratio, were increased in the IUGR compared to the CN group (oxLDL/LDL-C ratio: P<0.001).
Conclusion:
Our results support the hypothesis of a disturbed cholesterol supply in IUGR fetuses. Born SGA has been shown to be a risk factor for developing cardiovascular disease later in life. Since HDL-C has anti-inflammatory properties, a reduced HDL-C during fetal development, and an increase in atherogenic indices, might provide a link to this observation in IUGR fetuses.
