146 Abdominal Organ Growth in Intrauterine Growth Retardation: Fetal “Programming” Causing “Metabolic Syndrome” In Adult Age

Abstract

Background/aims: Fetal growth retardation may be associated with diseases and disorders in later life. This risk may be due to some impairment of the development of such organs as liver and kidney. In addition to general malnutrition of the fetus, preferential blood flow to the brain and the heart may furthermore deprive such organs as liver, spleen, and kidney on oxygen and macro-and micronutrients. As a consequences these organs may not develop normally, which predisposes to impaired outcome of the fetus. Persisting metabolic dysfunction may then cause such diseases as hypertension, cardiovascular disease, osteoporosis, schizophrenia, mental depression, breast cancer, and polycystic ovary syndrome in adult age. The aim of this study was to investigate the effects of maternal undernutrition on the growth of some abdominal organs. The size of the kidneys, spleen and liver in adequate for gestational age newborn infants (AGA) has been compared with that in small for gestational age (SGA) infants.

A New Phenotypical Variant of Intrauterine Growth Restriction?

“…Recently, fetal growth of liver and kidneys has been shown to be impaired in intrauterine growth-retarded infants, thus supporting the concept that fetal environmentally caused "programming" may increase the risk of functional defects and diseases in later life. 4 However, no morphologic markers of impaired fetal growth that persist later in life are known to date, with the possible exceptions of fingerprints pattern abnormalities and shape of the palm 5 or a high second-to-fourthdigit finger-length ratio 6,7 in specific SGA subsets. Here, we describe a series of children with idiopathic IUGR/ SGA showing previously unrecognized, phenotypical features, including auricle shape variations, bilaterally reduced or absent hemodynamic responses of the posterior communicating arteries (PCoAs) of the circle of Willis, joint hypermobility, soft skin, and bilateral subclinical cochlear dysfunction.…”

“…A total of 77 Italian children (boys: 32; girls: 45; gestational age at birth: 35.49 Ϯ 2.50 weeks; age at examination: 9.45 Ϯ 2.08 years) with antenatally diagnosed IUGR (as defined as insufficient fetal growth Ͻ2 SD [or Ͻ3rd percentile] below the mean for gestational age) and SGA birth (as defined as insufficient body size Ͻ2 SD [or Ͻ3rd percentile] below the mean for weight and/or length in relation to gestational age and gender for the Italian population),4,8 followed up in a regular clinical program, were enrolled, along with their parents…”