BACKGROUND: It has been suggested that an adverse fetal environment increases susceptibility to hypertension and cardiovascular disease in adult life. This increased risk may result from suboptimal development of the heart and main arteries in utero and from adaptive cardiovascular changes in conditions of reduced fetal growth. The aim of the present study was to evaluate whether reduced fetal growth is associated with fetal circulatory changes and cardiac dysfunction. METHODS AND RESULTS: This study was embedded in a population-based, prospective cohort study starting in early fetal life. Fetal growth characteristics and fetal circulation variables were assessed with ultrasound and Doppler examinations in 1215 healthy women. The fetal circulation was examined in relation to estimated fetal weight. Higher placental resistance indices were strongly associated with decreased fetal growth. Cerebral resistance showed a gradual decline with reduced fetal growth. Cardiac output, peak systolic velocity of the outflow tracts, and cardiac compliance showed a gradual reduction with diminished fetal growth, whereas intraventricular pressure gradually increased. CONCLUSIONS: Decreased fetal growth is associated with adaptive fetal cardiovascular changes. Cardiac remodeling and cardiac output changes are consistent with a gradual increase in afterload and compromised arterial compliance in conditions of decreased fetal growth. These changes have already begun to occur before the stage of clinically apparent fetal growth restriction and may contribute to the increased risk of cardiovascular disease in later life.
BACKGROUND: It has been suggested that an adverse fetal environment increases susceptibility to hypertension and cardiovascular disease in adult life. This increased risk may result from suboptimal development of the heart and main arteries in utero and from adaptive cardiovascular changes in conditions of reduced fetal growth. The aim of the present study was to evaluate whether reduced fetal growth is associated with fetal circulatory changes and cardiac dysfunction. METHODS AND RESULTS: This study was embedded in a population-based, prospective cohort study starting in early fetal life. Fetal growth characteristics and fetal circulation variables were assessed with ultrasound and Doppler examinations in 1215 healthy women. The fetal circulation was examined in relation to estimated fetal weight. Higher placental resistance indices were strongly associated with decreased fetal growth. Cerebral resistance showed a gradual decline with reduced fetal growth. Cardiac output, peak systolic velocity of the outflow tracts, and cardiac compliance showed a gradual reduction with diminished fetal growth, whereas intraventricular pressure gradually increased. CONCLUSIONS: Decreased fetal growth is associated with adaptive fetal cardiovascular changes. Cardiac remodeling and cardiac output changes are consistent with a gradual increase in afterload and compromised arterial compliance in conditions of decreased fetal growth. These changes have already begun to occur before the stage of clinically apparent fetal growth restriction and may contribute to the increased risk of cardiovascular disease in later life.
Authors: André Dallmann; Ibrahim Ince; Michaela Meyer; Stefan Willmann; Thomas Eissing; Georg Hempel Journal: Clin Pharmacokinet Date: 2017-11 Impact factor: 6.447
Authors: Marjolein N Kooijman; Hanneke Bakker; Albert J van der Heijden; Albert Hofman; Oscar H Franco; Eric A P Steegers; H Rob Taal; Vincent W V Jaddoe Journal: J Am Soc Nephrol Date: 2014-05-08 Impact factor: 10.121
Authors: Neil Hamill; Roberto Romero; Sonia S Hassan; Wesley Lee; Stephen A Myers; Pooja Mittal; Juan Pedro Kusanovic; Tinnakorn Chaiworapongsa; Edi Vaisbuch; Jimmy Espinoza; Francesca Gotsch; Angela Carletti; Luís F Gonçalves; Lami Yeo Journal: J Ultrasound Med Date: 2009-10 Impact factor: 2.153
Authors: Andrei Tintu; Ellen Rouwet; Stefan Verlohren; Joep Brinkmann; Shakil Ahmad; Fatima Crispi; Marc van Bilsen; Peter Carmeliet; Anne Cathrine Staff; Marc Tjwa; Irene Cetin; Eduard Gratacos; Edgar Hernandez-Andrade; Leo Hofstra; Michael Jacobs; Wouter H Lamers; Ingo Morano; Erdal Safak; Asif Ahmed; Ferdinand le Noble Journal: PLoS One Date: 2009-04-09 Impact factor: 3.240