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Published on: June 29, 2013
Cardiac function and arterial biophysical properties in small for gestational age infants: postnatal manifestations
Arvind Sehgal1, Tejas Doctor, Samuel Menahem
1Monash Newborn, Monash Children's Hospital, Melbourne, Australia; Department of Pediatrics, Monash University, Melbourne, Australia.
Insights
Small for gestational age (SGA) infants exhibit altered cardiac function and arterial properties compared to appropriate for gestational age (AGA) infants. These cardiovascular changes suggest potential long-term risks associated with intrauterine growth restriction.
Area of Science:
- Neonatal physiology
- Cardiovascular research
- Pediatric cardiology
Background:
- Intrauterine growth restriction (IUGR) impacts fetal development.
- Infants small for gestational age (SGA) may experience altered cardiovascular adaptation.
- Understanding these adaptations is crucial for long-term health outcomes.
Purpose of the Study:
- To compare cardiac function and arterial biophysical properties in term-born SGA versus appropriate for gestational age (AGA) infants.
- To test the hypothesis that intrauterine growth restriction alters cardiac and arterial indices.
Main Methods:
- Prospective observational study utilizing echocardiography.
- Comparison of cardiac and arterial indices between 20 SGA and 20 AGA infants.
- Analysis of demographic and echocardiographic data.
Main Results:
- SGA infants had lower Ponderal index and higher blood pressure than AGA infants.
- SGA infants showed reduced left ventricular output and increased diastolic dysfunction.
- SGA infants exhibited greater aortic intima-media thickness, arterial stiffness, and input impedance.
Conclusions:
- Term-born SGA infants demonstrate significant alterations in cardiac function and arterial biophysical properties.
- These findings support the link between in utero growth and later cardiovascular morbidity.
- Early cardiovascular changes in SGA infants warrant further investigation for long-term health implications.
Objective:
To investigate the differences in cardiac function and arterial biophysical properties between term-born appropriate for gestational age (AGA) infants and small for gestational age (SGA) infants. Our hypothesis was that adaptation to intrauterine growth restriction induces changes in cardiac and arterial indices.
Study Design:
This was a prospective observational echocardiographic evaluation of cardiac and arterial indices in SGA infants and AGA infants. Demographic and echocardiographic data were compared between 20 inborn term SGA infants with birth weight <3rd percentile for gestational age and 20 AGA infants.
Results:
The Ponderal index was significantly lower and blood pressure was significantly higher in the SGA infants compared with the AGA infants. Left ventricular output was lower in the SGA infants (170 ± 31 mL/kg/min vs 197 ± 39 mL/kg/min). Diastolic dysfunction was greater in the SGA infants (ie, reduced E and A wave velocities, higher E/A ratio [1.08 ± 0.16 vs 0.85 ± 0.07], and prolonged isovolumic relaxation time [73 ± 6.2 ms vs 62.6 ± 3.6 ms]). Aortic intima-media thickness was significantly greater in the SGA infants (822 ± 105 μm vs 694 ± 52 μm), as were arterial wall stiffness index and input impedance.
Conclusion:
Cardiac function and arterial biophysical properties were altered in the SGA infants. The findings complement the information on the association between in utero growth and cardiovascular morbidity in later life.
