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Cardiovascular Remodeling and Dysfunction Across a Range of Growth Restriction Severity in Small for Gestational Age

Yohei Akazawa1, Akira Hachiya, Shoko Yamazaki

  • 1Department of Pediatrics, Shinshu University School of Medicine.

Circulation Journal : Official Journal of the Japanese Circulation Society
|August 19, 2016
PubMed

Insights

Small for gestational age (SGA) infants exhibit cardiovascular changes, including remodeling and dysfunction. These effects worsen with increasing intrauterine growth restriction (IUGR) severity, even in mild cases.

Area of Science:

  • Neonatal Cardiology
  • Pediatric Cardiovascular Research
  • Fetal Development Studies

Background:

  • Small for gestational age (SGA) is a condition where infants are born smaller than expected for their gestational age.
  • Intrauterine growth restriction (IUGR) is a primary cause of SGA, indicating impaired fetal growth.
  • Understanding the cardiovascular implications of IUGR in SGA infants is crucial for early intervention.

Purpose of the Study:

  • To investigate cardiovascular structure and function in SGA infants.
  • To analyze how varying degrees of IUGR severity impact cardiovascular parameters.
  • To establish a baseline for cardiovascular assessment in SGA neonates.

Main Methods:

  • Prospective study comparing 38 SGA infants with 30 appropriate for gestational age (AGA) infants.
  • SGA infants classified into severe and mild groups based on IUGR severity.
  • Echocardiography used to assess cardiovascular structure and function at 1 week of age.

Main Results:

  • SGA infants (both mild and severe) demonstrated increased left ventricular diastolic dimensions and decreased global longitudinal strain compared to AGA infants.
  • Severe SGA infants showed reduced mitral annular early diastolic velocity and prolonged isovolumic relaxation time.
  • Elevated aortic intima-media thickness and arterial wall stiffness were observed in both SGA groups, worsening with IUGR severity.

Conclusions:

  • SGA infants experience cardiovascular remodeling and dysfunction, irrespective of IUGR severity.
  • The degree of cardiovascular impairment in SGA infants correlates with the severity of IUGR.
  • Early echocardiographic assessment is vital for identifying cardiovascular alterations in SGA infants.
Abstract

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