Early postnatal transitional circulation in fetal growth restricted neonates

Area of Science:

• Neonatal physiology
• Cardiovascular adaptation
• Fetal growth restriction

Background:

• Fetal growth restriction (FGR) can affect circulatory changes in newborns.
• Understanding these changes is crucial for neonatal care.

Purpose of the Study:

• To assess echocardiographic measures of cardiac output and blood flow in FGR neonates.
• To compare circulatory parameters between FGR and non-FGR neonates in the early postnatal period.

Main Methods:

• A prospective observational study involving FGR and non-FGR neonates.
• Echocardiography was used to measure left ventricular cardiac output, superior vena cava (SVC) flow, and ductus venosus (DV) flow.
• Measurements were taken on days one, two, and three after birth.

Main Results:

• Late-FGR neonates (gestational age ≥ 32 weeks) showed similar initial circulatory measurements compared to non-FGR neonates.
• By day three, Late-FGR neonates had lower left ventricular stroke volume and higher heart rates.
• Both groups exhibited decreases in left ventricular cardiac output and stroke volume from day one to three; SVC flow decreased in non-FGR but remained stable in Late-FGR.

Conclusions:

• Late-onset FGR has a limited impact on neonatal cardiac output and major blood flows in the early postnatal period.
• The primary circulatory adaptations in response to FGR appear to occur early in the transition to neonatal life.