Míriam Perez-Cruz1,2, Fàtima Crispi1,3,4, María Teresa Fernández1, Johanna Alexandra Parra1, Anna Valls1, María Dolores Gomez Roig5,6, Eduard Gratacós1,3,4. 1. BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, Barcelona, Spain. 2. Spanish Maternal & Child Health Network Retic SAMID, Barakaldo, Spain. 3. IDIBAPS, Barcelona, Spain. 4. Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain. 5. BCNatal - Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, Barcelona, Spainlgomezroig@hsjdbcn.org. 6. Spanish Maternal & Child Health Network Retic SAMID, Barakaldo, Spainlgomezroig@hsjdbcn.org.
Abstract
OBJECTIVE: To assess cardiovascular function and damage in term small-for-gestational-age (SGA) and intrauterine growth-restricted (IUGR) fetuses by echocardiography and biomarkers in cord blood. METHODS: This was a cohort study including 60 normal fetuses and 47 term small fetuses subclassified as small for gestational age (SGA) with estimated fetal weight (EFW) between the 3rd and 9th centiles and normal fetoplacental Doppler (n = 14) or intrauterine growth restriction (IUGR, n = 33) if EFW <3rd centile or EFW <10th centile together with cerebroplacental ratio <5th and/or mean uterine artery pulsatility index >95th centile. Fetal echocardiography included left myocardial performance index (MPI) and annular plane systolic excursion. Fetal B-type natriuretic peptide (BNP), troponin-I, heart-type fatty acid-binding proteins (H-FABP), and homocysteine concentrations were measured in cord blood collected at delivery. RESULTS: Both SGA and IUGR cases presented echocardiographic signs of systolic and diastolic dysfunction with increased MPI (mean controls 0.43 [SD 0.12], SGA 0.47 [0.03], and IUGR 0.57 [0.08], p < 0.01) and decreased mitral annular plane systolic excursion (controls 6.0 mm [1.0], SGA 5.5 mm [0.6], and IUGR 4.9 mm [0.8], p = 0 01). IUGR fetuses presented increased levels of cord blood BNP (controls 17.2 pg/mL [11.5], SGA 22.4 pg/mL [10.7], and IUGR 31.2 pg/mL [26.8], p < 0.01). Troponin I was increased in both SGA and IUGR cases (controls 0.004 ng/mL [0.007], SGA 0.012 ng/mL [0.02], and IUGR 0.018 ng/mL [0.05], p < 0.01). H-FABP and homocysteine showed similar values among groups. CONCLUSIONS: Cardiac dysfunction and cell damage is a common feature of term SGA and IUGR fetuses despite of the severity criteria for perinatal outcome. Further research is needed to evaluate the potential long-term consequences on their cardiovascular system.
OBJECTIVE: To assess cardiovascular function and damage in term small-for-gestational-age (SGA) and intrauterine growth-restricted (IUGR) fetuses by echocardiography and biomarkers in cord blood. METHODS: This was a cohort study including 60 normal fetuses and 47 term small fetuses subclassified as small for gestational age (SGA) with estimated fetal weight (EFW) between the 3rd and 9th centiles and normal fetoplacental Doppler (n = 14) or intrauterine growth restriction (IUGR, n = 33) if EFW <3rd centile or EFW <10th centile together with cerebroplacental ratio <5th and/or mean uterine artery pulsatility index >95th centile. Fetal echocardiography included left myocardial performance index (MPI) and annular plane systolic excursion. Fetal B-type natriuretic peptide (BNP), troponin-I, heart-type fatty acid-binding proteins (H-FABP), and homocysteine concentrations were measured in cord blood collected at delivery. RESULTS: Both SGA and IUGR cases presented echocardiographic signs of systolic and diastolic dysfunction with increased MPI (mean controls 0.43 [SD 0.12], SGA 0.47 [0.03], and IUGR 0.57 [0.08], p < 0.01) and decreased mitral annular plane systolic excursion (controls 6.0 mm [1.0], SGA 5.5 mm [0.6], and IUGR 4.9 mm [0.8], p = 0 01). IUGR fetuses presented increased levels of cord blood BNP (controls 17.2 pg/mL [11.5], SGA 22.4 pg/mL [10.7], and IUGR 31.2 pg/mL [26.8], p < 0.01). Troponin I was increased in both SGA and IUGR cases (controls 0.004 ng/mL [0.007], SGA 0.012 ng/mL [0.02], and IUGR 0.018 ng/mL [0.05], p < 0.01). H-FABP and homocysteine showed similar values among groups. CONCLUSIONS:Cardiac dysfunction and cell damage is a common feature of term SGA and IUGR fetuses despite of the severity criteria for perinatal outcome. Further research is needed to evaluate the potential long-term consequences on their cardiovascular system.
Authors: Lena Braginsky; Steven J Weiner; George R Saade; Michael W Varner; Sean C Blackwell; Uma M Reddy; John M Thorp; Alan T N Tita; Russell S Miller; David S McKenna; Edward K S Chien; Dwight J Rouse; Yasser Y El-Sayed; Yoram Sorokin; Steve N Caritis Journal: Am J Perinatol Date: 2021-08-31 Impact factor: 1.862
Authors: Mariona Guitart-Mampel; Diana L Juarez-Flores; Lina Youssef; Constanza Moren; Laura Garcia-Otero; Vicente Roca-Agujetas; Marc Catalan-Garcia; Ingrid Gonzalez-Casacuberta; Ester Tobias; José C Milisenda; Josep M Grau; Fàtima Crispi; Eduard Gratacos; Francesc Cardellach; Glòria Garrabou Journal: J Cell Mol Med Date: 2019-04-02 Impact factor: 5.310
Authors: Jezid Miranda; Rui V Simões; Cristina Paules; Daniel Cañueto; Miguel A Pardo-Cea; María L García-Martín; Francesca Crovetto; Rocio Fuertes-Martin; Monica Domenech; María D Gómez-Roig; Elisenda Eixarch; Ramon Estruch; Stefan R Hansson; Nuria Amigó; Nicolau Cañellas; Fatima Crispi; Eduard Gratacós Journal: Sci Rep Date: 2018-09-11 Impact factor: 4.379