Intrauterine growth restriction results in persistent vascular mismatch in adulthood

Abstract

Maternal nutrient reduction induces intrauterine growth restriction (IUGR), increasing risks of chronic diseases later in life, including cardiovascular dysfunction. Using ultrasound, we determined regional blood flow, blood vessel sizes, and distensibility in IUGR baboons (8 males, 8 females, 8.8 years, similar to 35 human years) and controls (12 males, 12 females, 9.5 years). The measured blood vessels were larger in size in the males compared to females before but not after normalization to body surface area. Smaller IUGR normalized blood vessel sizes were observed in the femoral and external iliac arteries but not the brachial or common carotid arteries and not correlated significantly with birth weight. Mild decrease in distensibility in the IUGR group was seen in the iliac but not the carotid arteries without between-sex differences. In IUGR baboons there was increased carotid arterial blood flow velocity during late systole and diastole. Overall, our findings support the conclusion that region specific vascular and haemodynamic changes occur with IUGR, which may contribute to the occurrence of later life cardiac dysfunction. The pattern of alteration observed suggests vascular redistribution efforts in response to challenges in the perinatal period may persist into adulthood. Further studies are needed to determine the life course progression of these changes.

‘Stiffening the sinews of the heart’

“…The nature of these postnatal changes fit with the fibrosis demonstrated in the article reviewed here and Muralimanoharan et al (2017). The pattern of vascular distribution observed in IUGR offspring is reminiscent of the changes that occur in fetuses challenged by hypoxia or undernutrition (Cohn et al 1974;Kuo et al 2018). Further studies are needed to determine the life course progression of the consequences of these programmed structural alterations.…”

“…At age ∼9 years (∼35 human years equivalent), IUGR baboons had smaller hindlimb but not brachial or common carotid arteries than controls and increased carotid blood flow velocity (Kuo et al . ). Overall these data indicate that region specific vascular and haemodynamic changes that occur with IUGR persist postnatally to and likely contribute to later life cardiac dysfunction.…”

“…; Kuo et al . ). Further studies are needed to determine the life course progression of the consequences of these programmed structural alterations.…”

Newborn with a painless lump over the clavicle

“…Region‐specific vascular changes have been reported in IUGR newborns: the pattern of anomalies suggests a vascular redistribution effort in response to challenges in the perinatal period. Considering these data, differences in pulsatility and regional blood flow could have played a role in the abnormal development of the right clavicle in our IUGR patient.…”

“…4 The mechanical injury could otherwise be due to the role of a pulsating right subclavian artery, rather than interrupted formation of ossification centres as it has been demonstrated that the junction of these centres is actually more lateral. 5 Region-specific vascular changes have been reported in IUGR newborns 6 : the pattern of anomalies suggests a vascular redistribution effort in response to challenges in the perinatal period. Considering these data, differences in pulsatility and regional blood flow could have played a role in the abnormal development of the right clavicle in our IUGR patient.…”