胎盤血管機能不全,胎児・幼児の成長,心血管発達:R世代の研究
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
まとめ
より高い動脈抵抗によって示される不適正な胎児の栄養は,胎児の成長の遅さと子供の心血管発達の変化に関連しています. これらの影響は子供時代まで持続し,体組成と血圧に影響を与えます.
科学分野:
- ペリナトロジー (Perinatology) とは
- 発達生物学 発達生物学について
- 心血管生理学 心血管の生理学
背景:
- 不適正な胎児の栄養は,早期の成長と心血管の発達に影響を与える可能性があります.
- 胎盤前および胎盤前血管機能は胎児の健康状態の重要な指標である.
研究 の 目的:
- 帯動脈と子宮動脈の抵抗指数と胎児/幼児の成長と心血管発達との関連を調査する.
- 妊娠3分の1の血管抵抗が長期的な成長と心血管疾患を予測するかどうかを判断する.
主な方法:
- 6716人の母親と子どもを対象とした人口ベースの前向きなコホート研究.
- 動脈の脈動性指数,子宮動脈抵抗指数,胎児の成長の第3四半期測定.
- 6歳までの子供の成長,体脂肪の分布,左心室質量,血圧の評価を繰り返し行いました.
主要な成果:
- 妊娠三半期における帯動脈と子宮動脈の血管抵抗の上昇は,胎児の成長の低下と出生時に胎児のサイズが小さくなることと相関していた.
- この成長の差異は6歳まで続いたが,減った.
- 動脈抵抗 (子宮ではない) の上昇は,出生体重に関係なく,子供のBMI,体脂肪,静脈血圧,左下心室質量などの上昇と関連していました.
結論:
- 第3 trimesterにおける胎児-胎盤血管抵抗性の増加は,胎児の成長率の低下と関連しています.
- より高い胎児・胎盤血管抵抗は,小児期における有害な心血管適応を予測する.
- 子宮胎盤血管抵抗は,子供の心血管疾患との類似の関連性を示さなかった.
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