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Vascular aging and cardiac maladaptation in growth-restricted preterm infants



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.


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).


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

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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.

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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).

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