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Disfunción vascular placentaria, crecimiento fetal y infantil y desarrollo cardiovascular: el estudio de la
Romy Gaillard1, Eric A P Steegers, Henning Tiemeier
1Generation R Study Group (R.G., V.W.V.J.) and the Departments of Epidemiology (R.G., H.T., A.H., V.W.V.J.), Paediatrics (R.G., V.W.V.J.), Obstetrics and Gynaecology (E.A.P.S.), and Child and Adolescent Psychiatry (H.T.), Erasmus Medical Center, Rotterdam, The Netherlands.
Circulation
|October 19, 2013
Resumen
La nutrición fetal subóptima, indicada por una mayor resistencia de la arteria umbilical, está relacionada con un crecimiento fetal más lento y un desarrollo cardiovascular infantil alterado. Estos efectos persisten en la infancia, afectando la composición corporal y la presión arterial.
Área de la Ciencia:
- Perinatología Perinatología.
- Biología del desarrollo Biología del desarrollo.
- Fisiología cardiovascular fisiología cardiovascular.
Sus antecedentes:
- La nutrición fetal subóptima puede afectar el crecimiento temprano y el desarrollo cardiovascular.
- La función vascular feto-placentaria y utero-placentaria son indicadores clave del bienestar del feto.
Objetivo del estudio:
- Investigar la asociación entre los índices de resistencia de las arterias umbilical y uterina y el crecimiento fetal / infantil y el desarrollo cardiovascular.
- Para determinar si la resistencia vascular en el tercer trimestre predice el crecimiento a largo plazo y los resultados cardiovasculares.
Principales métodos:
- Un estudio de cohorte prospectivo basado en la población de 6716 madres y niños.
- Mediciones del tercer trimestre del índice de pulsabilidad de la arteria umbilical, el índice de resistencia de la arteria uterina y el crecimiento fetal.
- Evaluaciones repetidas del crecimiento infantil, distribución de la grasa corporal, masa ventricular izquierda y presión arterial hasta los 6 años.
Principales resultados:
- Una mayor resistencia vascular de la arteria umbilical y uterina en el tercer trimestre se correlacionó con un menor crecimiento fetal y un tamaño de nacimiento más pequeño.
- Estas diferencias de crecimiento persistieron, aunque disminuyeron, hasta los 6 años.
- La resistencia elevada de la arteria umbilical (no uterina) se asoció con un mayor IMC infantil, grasa corporal, presión arterial sistólica y masa ventricular inferior izquierda, independientemente del peso al nacer.
Conclusiones:
- El aumento de la resistencia vascular feto-placentaria en el tercer trimestre se asocia con tasas de crecimiento fetal reducidas.
- Una mayor resistencia vascular feto-placentaria predice adaptaciones cardiovasculares adversas en la infancia.
- La resistencia vascular utero-placentaria no mostró asociaciones similares con los resultados cardiovasculares en la infancia.
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