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[Perinatal outcome and cardiac dysfunction in preterm growth-restricted neonates in relation to placental impairment
Júlia Candel Pau1, Félix Castillo Salinas2, Josep Perapoch López3
1Fundación Institut de Recerca de la Vall d'Hebron (VHIR), Barcelona, España.
Insights
Severe intrauterine growth restriction (IUGR) in preterm infants significantly increases neonatal morbidity and mortality. This risk, along with cardiovascular dysfunction biomarkers, is proportional to the severity of placental insufficiency.
Area of Science:
- Neonatology
- Perinatology
- Cardiovascular Research
Background:
- Intrauterine growth restriction (IUGR) and prematurity are linked to adverse perinatal outcomes and fetal cardiovascular programming.
- Limited research exists on placenta-related IUGR's specific impact on preterm infants' cardiovascular health.
Purpose of the Study:
- To compare neonatal outcomes and cardiovascular dysfunction biomarkers in preterm infants with and without placenta-related IUGR.
- To assess the relationship between IUGR severity, determined by fetal Doppler, and these outcomes.
Main Methods:
- A prospective cohort study involving preterm infants with and without placenta-related IUGR.
- Severity of IUGR was classified using prenatal umbilical artery Doppler scans.
- Comparative analysis of perinatal outcomes, neonatal morbidity/mortality, and cord blood cardiovascular biomarkers.
Main Results:
- IUGR infants had lower birth weight, length, head circumference, and Apgar scores.
- Increased levels of neonatal and cardiovascular dysfunction biomarkers were observed in IUGR infants.
- These adverse effects were more pronounced with increasing IUGR severity.
Conclusions:
- Placenta-related IUGR in preterm infants elevates neonatal morbidity and mortality, regardless of gestational age.
- The severity of IUGR directly correlates with increased adverse outcomes.
- Placental function and IUGR severity influence cardiovascular dysfunction biomarkers at birth.
Introduction:
Intrauterine growth restriction (IUGR) and prematurity have been associated with increased perinatal morbidity and mortality and also with cardiovascular foetal programming. However, there are few studies on the impact of placenta-related IUGR on perinatal outcomes and cardiovascular biomarkers in pre-term infants.
Objectives:
To determine differences in neonatal morbidity, mortality and cord blood biomarkers of cardiovascular dysfunction between pre-term placenta-related IUGR and non-IUGR new-borns, and to analyse their relationship with the severity of IUGR according to foetal Doppler evaluation.
Material And Methods:
Prospective cohort study: pre-term infants with placenta-related IUGR and matched pre-term infants without IUGR. A Doppler scan was performed, and placenta-IUGR was classified according to severity. Comparative analysis of perinatal outcomes, neonatal morbidity and mortality, and cord blood levels of biomarkers of cardiovascular dysfunction was performed.
Results:
IUGR new-borns present lower weight, length, head circumference, and Apgar score at birth, as well as increased neonatal and cardiovascular dysfunction biomarker levels, compared with pre-term new-borns without IUGR. These differences increase with the severity of IUGR determined by prenatal umbilical artery Doppler scan.
Conclusions:
Placenta-related-IUGR pre-term infants, irrespective of gestational age, present increased neonatal morbidity and mortality that is significantly proportional to the severity of IUGR. Placental impairment and severity also determine levels of cardiovascular dysfunction biomarkers at birth.
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