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Developmental Differences in Left Ventricular Strain in IUGR vs. Control Children the First Three Months of Life
Olov Änghagen1,2, Jan Engvall3,4, Tomas Gottvall5
1Crown Princess Victoria's Child and Youth Hospital, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. olov.anghagen@liu.se.
Insights
Intrauterine growth restriction (IUGR) impairs cardiac function in newborns. Left ventricular longitudinal strain (LVLS) did not improve by 3 months in IUGR infants, unlike healthy controls, indicating persistent cardiac impact.
Area of Science:
- Neonatal cardiology
- Pediatric cardiovascular research
- Fetal development and health
Background:
- Intrauterine growth restriction (IUGR) may impact early cardiovascular function.
- Longitudinal data on left ventricular longitudinal strain (LVLS), a body size-independent cardiac measure, is lacking.
- Hypothesized impaired cardiac function in IUGR newborns persisting to 3 months.
Purpose of the Study:
- To investigate cardiac function in newborns with IUGR.
- To assess the persistence of cardiac function impairment at 3 months of age.
- To evaluate left ventricular longitudinal strain (LVLS) as a marker of cardiac health in IUGR.
Main Methods:
- Prospective cohort study comparing IUGR infants with healthy controls.
- Echocardiograms performed at birth and 3-4 months of age.
- Left ventricular longitudinal strain (LVLS) measured and compared between groups.
Main Results:
- No significant difference in LVLS between IUGR and control groups at birth.
- IUGR group showed no significant LVLS change at 3-4 months.
- Control group demonstrated a significant increase in LVLS (P < 0.001) by 3-4 months.
- LVLS was significantly lower in the IUGR group at 3-4 months (P = 0.003).
Conclusions:
- Lack of LVLS increase in IUGR infants suggests a direct impact on cardiac function in early life.
- IUGR may lead to persistent cardiac functional deficits in the first months of life.
- Findings highlight the importance of monitoring cardiac health in IUGR infants.
Background:
Intrauterine growth restriction (IUGR) may directly affect cardiovascular function in early life. Longitudinal data on left ventricular longitudinal strain (LVLS), a key measure of cardiac function independent of body size, is not available. We hypothesize impaired cardiac function among IUGR newborns and persistence of the impairment until age 3 months.
Method:
This is a prospective cohort study of consecutive pregnancies where IUGR was identified at 18-38 weeks gestational age (GA) with healthy controls randomly selected at 18-20 weeks GA. Echocardiograms were performed at birth and at age 3-4 months, and then compared.
Results:
At birth, mean (SD) LVLS did not differ between the IUGR group [N = 19; - 15.76 (3.12) %] and controls [N = 35; - 15.53 (3.56) %]. The IUGR group demonstrated no significant change in LVLS at age 3-4 months [- 17.80 (3.82) %], while the control group [- 20.91 (3.31) %] showed a significant increase (P < 0.001). Thus, LVLS was lower in the IUGR group at age 3-4 months (P = 0.003).
Conclusion:
The lack of increase in LVLS may suggest that IUGR has a direct impact on cardiac function as early as during the first months of life. Trial registration Clinical trials.gov Identifier: NCT02583763, registration October 22, 2015. Retrospectively registered September 2014-October 2015, thereafter, registered prospectively.
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