Developmental Differences in Left Ventricular Strain in IUGR vs. Control Children the First Three Months of Life
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Updated: Sep 29, 2025
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
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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