Fetal growth restriction in preterm infants and cardiovascular function at five years of age.
OBJECTIVE
We have previously reported an increased cardiac workload in newborn preterm small (SGA) infants, but not in infants appropriate for gestational age (AGA). We hypothesized that these cardiovascular changes will persist at follow-up at 5 years of age.


METHODS
We assessed blood pressure, echocardiography, and skin perfusion with laser Doppler flowmetry in 22 SGA (821 +/- 248 g, 28.5 +/- 2.5 gestational weeks) and in 25 AGA (1065 +/- 241 g, 27.6 +/- 0.8 weeks) preterm children at age 5 years. Laser Doppler flowmetry also was used in 13 control children (3982 +/- 425 g, 40.4 +/- 1.8 weeks).


RESULTS
The preterm children in both the SGA and AGA groups had similar higher systolic blood pressures, increased interventricular septum thicknesses, and smaller left ventricular end-diastolic diameters compared with population reference values. Maximal endothelium-independent perfusion to sodium nitroprusside was higher and maximal endothelium-dependent perfusion to acetylcholine reached a plateau earlier in the AGA preterm group than in the control group.


CONCLUSIONS
Prematurity may impair cardiovascular function independently of intrauterine growth restriction. Altered cardiac dimensions and differences in perfusion responses may reflect increased cardiac afterload.
Mikkola
Kaija
K
Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland. kaija.mikkola@hus.fi
Leipälä
Jaana
J
Boldt
Talvikki
T
Fellman
Vineta
V
D001794:Blood Pressure / Q000502:physiology*; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D016022:Case-Control Studies; D002508:Cephalometry; D002675:Child, Preschool; D003326:Coronary Circulation / Q000502:physiology*; D003971:Diastole / Q000502:physiology; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D005500:Follow-Up Studies; D006346:Heart Septum / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D017078:Laser-Doppler Flowmetry; D008297:Male; D012737:Sex Factors; D013599:Systole / Q000502:physiology; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000502:physiology