与子宫内生长相关的胎儿血液动力学适应性变化:R世代研究
Bero O Verburg1, Vincent W V Jaddoe, Juriy W Wladimiroff
1Department of Epidemiology and Biostatistics, Erasmus Medical Center, Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Circulation
|January 24, 2008
概括
减少胎儿生长与胎儿的心血管变化有关,包括心脏输出量变化和后负载增加. 这些早期适应可能会增加成人心血管疾病的风险.
科学领域:
- 围产儿医学 围产儿医学
- 心血管生理学心血管生理学
- 发展生物学 发展生物学
背景情况:
- 不利的胎儿环境可能会使个体易患成人高血压和心血管疾病.
- 心脏和主要动脉在子宫内不理想发育,或由于胎儿生长减少而导致的适应性心血管变化是潜在的机制.
- 这项研究调查了胎儿生长减缓与胎儿循环改变和心脏功能障碍之间的关联.
研究的目的:
- 评估胎儿生长减缓与胎儿循环系统变化之间的关联.
- 为了评估发育减缓的胎儿的心脏功能障碍.
- 了解心血管风险的早期标志物.
主要方法:
- 基于人口的前性队列研究.
- 对1215名健康妇女进行了超声波和多普勒检查.
- 评估胎儿生长,胎盘阻力,大脑阻力,心脏输出,流出管道速度,心脏顺应性和腹腔内压力与胎儿估计体重相关的情况.
主要成果:
- 较高的胎盘抵抗指数与胎儿生长减少有很强的相关性.
- 大脑抵抗性显示,随着胎儿生长的减少,其逐渐下降.
- 心脏输出量,缩速度峰值和心脏顺应性下降,而心室内压力随着胎儿生长的减少而增加.
结论:
- 胎儿生长减缓与适应性胎儿心血管变化有关,包括心脏重塑和心脏输出改变.
- 这些变化表明后负载增加和动脉顺应受损,发生在临床胎儿生长限制之前.
- 这些产前适应可能会导致晚年心血管疾病的风险增加.
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