An Automated Oscillometric Technique for Estimating Mean Arterial Pressure in Critically III Newborns

Background: Large for gestational age (LAG) neonates who had been exposed to an intrauterine environment of either diabetes or maternal obesity are at increased risk of developing the metabolic syndrome. This can be explained by exposure to high glucose and insulin levels in utero which alter fetal adaptation and programming. Objectives: The aim of the study was to evaluate the onset of preclinical atherosclerosis in utero. Methods: We measured umbilical artery wall thickness (ruWT) in the third trimester by obstetric ultrasound and umbilical artery intima-media thickness (uIMT) in pathologic specimens of umbilical cords obtained shortly after delivery and investigated the relation between these measurements and serum insulin level and C-peptide level in cord blood and assessed insulin resistance with the homeostasis model assessment of insulin resistance (HOMA-IR) in infants of diabetic mothers (IDMs), i.e. the study group, which was divided into a large for gestational age group (LGA)-IDM group and an appropriate for gestational age group (AGA)-IDM group and compared with a control group. Results: The LGA-IDM group had significantly higher insulin (p < 0.001), C-peptide (p = 0.018) and HOMA-IR levels (p < 0.001) compared with the AGA-IDM and control groups. The LGA-IDM group had significantly larger ruWT (p = 0.013) and uIMT (p < 0.001) compared with the AGA-IDM and the control groups. The LGA-IDM group had increased uIMT and ruWT that correlated with the severity of maternal hyperglycemia. Conclusions: Measurement of ruWT in the third trimester is feasible, reproducible and strongly correlated with pathological serum insulin, C-peptide in cord blood and HOMA-IR levels.

show abstract

“…An oscillometric monitor that has been demonstrated to be reliable was used to determine mean blood pressure of the newborns [11]. …”

Section: Methodsmentioning

confidence: 99%

Umbilical Artery Intima-Media and Wall Thickness in Infants of Diabetic Mothers

Sarikabadayi

Aydemir²,

Kanmaz³

et al. 2012

Neonatology

View full text Add to dashboard Cite

show abstract

“…The exclusion criterions were: asphyxiated at birth, major congenital anomalies and blood pressures alterations on the 5th day of birth. An oscillometric monitor that has been demonstrated to be reliable was used to determine mean blood pressure in the newborn infants [15]. Mean blood pressure measurements were obtained and an average of three measurements was calculated.…”

Section: Methodsmentioning

confidence: 99%

Macrosomic Newborns of Diabetic Mothers Are Associated with Increased Aortic Intima-Media Thickness and Lipid Concentrations

Akçakuş

Köklü²,

Baykan³

et al. 2006

Horm Res Paediatr

View full text Add to dashboard Cite

Background/Aims: Exposure to diabetes in utero has been established as a significantrisk factor for some of components of metabolic syndrome. A few studies have examined relationship between the metabolic syndrome and echocardiographic left ventricular (LV) mass. We aimed to investigate relationship between abdominal aortic intima-media thickness (aIMT), LV mass and lipid profile in macrosomic newborns. Methods: Abdominal aIMT was measured in 30 macrosomic neonates of diabetic mothers (group A), 30 macrosomic neonates of healthy mothers (group B) and 30 healthy neonates (group C). Lipid profile and LV mass were determined. Result: Mean aIMT was significantly higher in groups A and B (0.489 ± 0.015, 0.466 ± 0.019 mm, respectively) than in controls (0.375 ± 0.024 mm). Weight-adjusted aIMT in group A was significantly higher than in groups B and C. Macrosomia was associated with increased lipid concentrations. Both LV mass indexed for BSA (body surface area) and birth weight measurements were significantly increased in group A compared with control. Conclusions: Macrosomic neonates of diabetic mothers have significant aIMT and LV mass indexed for BSA and birth weight with lipid alterations. It might play a role in the pathogenesis of atherosclerosis in adult life.

show abstract

“…12 Consequently, either site was used in clinical practice. Previous studies [13][14][15][16][17] have demonstrated similar BP results with either the oscillometric or intra-arterial method: therefore, we combined all BP data for our analyses.…”

Section: Bp Measurementsmentioning

confidence: 99%