Cardiac morphology in neonates with fetal growth restriction

Abstract

Objective: Assess effects of fetal growth restriction (FGR) on cardiac modelling in premature and term neonates.Study design: Prospective echocardiographic cohort study comparing FGR neonates (n=21) and controls (n=41) with normal prenatal growth and circulation.Results: Unadjusted for gestational age, birth weight, sex and twin/singleton, Late-FGR neonates had smaller hearts than controls, with globular left ventricles and symmetrical right ventricles. Adjusted estimates showed smaller left ventricles and similarly sized right ventricles, with symmetrical left and right ventricles. Early-FGR (compared with Late-FGR) had smaller hearts and globular left ventricles in unadjusted estimates, but after adjustment, sizes and shapes were similar.Conclusion: FGR had signi cant impact on cardiac modelling, both unadjusted and when adjusted for gestational age, birth weight, sex and twin/singleton. The adjustments, however, re ned the results notably and represents more speci c the effects of FGR, thus underscoring the importance of adjustments in such studies.

Measures of Fetal Growth and Cardiac Structure in Stillbirths With Placental Maternal Vascular Malperfusion: Evidence for Heart Weight Sparing and Structural Cardiac Alterations in Humans

“…[2][3][4][5] Further, FGR is associated with cardiac remodeling and dysfunction in infancy and childhood, including hypertrophy, spherical shape, and increased wall thickness. [6][7][8][9][10][11][12] These cardiac changes may persist through adolescence and adulthood and contribute to increased CVD risk across the life course. 13 Understanding the mechanistic pathways linking birth outcomes with offspring cardiovascular health is critical to improve risk stratification and to develop interventions to promote cardiovascular health across the life course.…”