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Vascular aging and cardiac maladaptation in growth-restricted preterm infants

Journal of Perinatology volume 38, pages 92–97 (2018)Cite this article

Subjects

Abstract

Objective:

To assess arterial morphology and mechanics in preterm infants with fetal growth restriction (FGR) compared with those appropriate for gestational age (AGA) in the early neonatal period.

Study design:

This observational study involved 20 preterm FGR infants (28 to 32 weeks) of gestational age (GA) and birth weight (BW) <10th centile and 20 preterm AGA infants. Vascular ultrasound was performed to measure aortic properties.

Results:

GA and BW of FGR and AGA infants were 29.8±1.3 vs 30±0.9 weeks (P=0.78) and 923.4±168 vs 1403±237 g (P<0.001), respectively. At 10.5±1.3 (s.d.) days after birth, blood pressure (systolic 51±3 vs 46±4 mm Hg, P<0.001) and maximum aorta intima–media thickness (621±76 vs 479±54 μm; P<0.001) were significantly higher in FGR infants. Arterial wall stiffness and peripheral resistance were also increased in the FGR infants (2.36±0.24 vs 2.14±0.24, P=0.008 and 22.2±5 vs 13.7±2.3 mm Hg min ml−1, P<0.001), respectively. Significant correlations between vascular mechanics and cardiac function were observed (resistance vs E/E', r=0.7 and Tei index, r=0.79).

Conclusion:

Maladaptive arterial–ventricular coupling was noted. Early detection may aid in early therapeutic strategies such as afterload reduction.

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Acknowledgements

We thank Dr Andra Malikiwi for assistance with aIMT measurements. This study was supported by an ANZ Trustees/Equity Trustees Medical Research & Technology in Victoria Grant, a National Health and Medical Research Council and National Heart Foundation of Australia Fellowship (GRP: 1105526), an Australian Research Council Future Fellowship (SLM: FT130100650), a Rebecca L Cooper Medical Research Foundation Fellowship (GRP) and the Victorian Government’s Operational Infrastructure Support Program.

Author information

Author notes

  1. S L Miller and G R Polglase: These two authors contributed equally to this work.

Authors and Affiliations

  1. Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia

    A Sehgal

  2. Department of Pediatrics, Monash University, Melbourne, VIC, Australia

    A Sehgal

  3. The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia

    B J Allison, S L Miller & G R Polglase

  4. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    S M Gwini

  5. Paediatric and Fetal Cardiac Units, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia

    S Menahem

  6. Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia

    S L Miller & G R Polglase

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Correspondence to A Sehgal.

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Sehgal, A., Allison, B., Gwini, S. et al. Vascular aging and cardiac maladaptation in growth-restricted preterm infants. J Perinatol 38, 92–97 (2018). https://doi.org/10.1038/jp.2017.135

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