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Updated: May 4, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Left ventricular dimensions, systolic functions, and mass in term neonates with symmetric and asymmetric intrauterine
Bahar Cinar1, Ahmet Sert2, Zeynel Gokmen3
11Department of Pediatrics,Konya Training and Research Hospital,Konya,Turkey.
Insights
Neonates with symmetric and asymmetric intrauterine growth restriction show reduced heart dimensions and mass, but preserved systolic function. Maternal factors like low socioeconomic status and short stature are linked to intrauterine growth restriction.
Area of Science:
- Neonatal Cardiology
- Fetal Development
- Pediatric Echocardiography
Background:
- Previous research indicates cardiac structural changes and dysfunction in fetuses with intrauterine growth restriction (IUGR).
- Limited data exists on left ventricular (LV) dimensions and mass in neonates with symmetric vs. asymmetric IUGR.
- This study addresses the gap by evaluating LV characteristics in these neonates.
Purpose of the Study:
- To assess left ventricular dimensions, systolic function, and mass in neonates with symmetric and asymmetric IUGR.
- To identify maternal risk factors associated with IUGR.
- To compare findings with healthy, appropriate-for-gestational-age neonates.
Main Methods:
- Transthoracic echocardiography was performed on 62 asymmetric IUGR neonates, 39 symmetric IUGR neonates, and 50 controls.
- Key echocardiographic parameters including LV dimensions, wall thickness, mass, and mass index were measured.
- Maternal risk factors were also assessed.
Main Results:
- Asymmetric IUGR neonates had significantly smaller LV end-systolic and end-diastolic diameters and posterior wall dimensions than controls.
- Symmetric IUGR neonates showed significantly lower LV end-diastolic diameter compared to controls.
- Both IUGR groups exhibited reduced relative posterior wall thickness, LV mass, and LV mass index versus controls, with preserved systolic function.
Conclusions:
- Neonates with symmetric and asymmetric IUGR demonstrate decreased LV dimensions, wall thickness, mass, and mass index but maintained systolic function.
- Low socioeconomic status, short maternal stature, and low maternal weight are identified risk factors for developing IUGR.
- This study is the first to compare LV dimensions, mass, and function in neonates with symmetric versus asymmetric IUGR.
Background:
Previous studies have demonstrated structural changes in the heart and cardiac dysfunction in foetuses with intrauterine growth restriction. There are no available data that evaluated left ventricular dimensions and mass in neonates with symmetric and asymmetric intrauterine growth restriction. Therefore, we aimed to evaluate left ventricular dimensions, systolic functions, and mass in neonates with symmetric and asymmetric intrauterine growth restriction. We also assessed associated maternal risk factors, and compared results with healthy appropriate for gestational age neonates.
Methods:
In all, 62 asymmetric intrauterine growth restriction neonates, 39 symmetric intrauterine growth restriction neonates, and 50 healthy appropriate for gestational age neonates were evaluated by transthoracic echocardiography.
Results:
The asymmetric intrauterine growth restriction group had significantly lower left ventricular end-systolic and end-diastolic diameters and posterior wall diameter in systole and diastole than the control group. The symmetric intrauterine growth restriction group had significantly lower left ventricular end-diastolic diameter than the control group. All left ventricular dimensions were lower in the asymmetric intrauterine growth restriction neonates compared with symmetric intrauterine growth restriction neonates (p>0.05), but not statistically significant except left ventricular posterior wall diameter in diastole (3.08±0.83 mm versus 3.54 ±0.72 mm) (p<0.05). Both symmetric and asymmetric intrauterine growth restriction groups had significantly lower relative posterior wall thickness (0.54±0.19 versus 0.48±0.13 versus 0.8±0.12), left ventricular mass (9.8±4.3 g versus 8.9±3.4 g versus 22.2±5.7 g), and left ventricular mass index (63.6±29.1 g/m2 versus 54.5±24.4 g/m2 versus 109±28.8 g/m2) when compared with the control group.
Conclusions:
Our study has demonstrated that although neonates with both symmetric and asymmetric intrauterine growth restriction had lower left ventricular dimensions, relative posterior wall thickness, left ventricular mass, and mass index when compared with appropriate for gestational age neonates, left ventricular systolic functions were found to be preserved. In our study, low socio-economic level, short maternal stature, and low maternal weight were found to be risk factors to develop intrauterine growth restriction. To our knowledge, our study is the first to evaluate left ventricular dimensions, wall thicknesses, mass, and systolic functions in neonates with intrauterine growth restriction and compare results with respect to asymmetric or symmetric subgroups.
