Arterial wall thickness and blood pressure in children who were born small for gestational age: correlation with umbilical cord high-sensitivity C-reactive protein.
BACKGROUND
Small for gestational age (SGA) infants have an increased risk of later cardiovascular disease. At birth, high sensitivity-C reactive protein (hs-CRP), a prognostic marker of cardiovascular disease, is significantly higher in SGA than in appropriate for gestational age (AGA) infants.


OBJECTIVE
To measure aortic and carotid intima-media thickness (aIMT, cIMT) and blood pressure (BP) in children (aged 3-5 years) who were born SGA and AGA, and to assess the correlation between hs-CRP concentrations obtained at birth and these haemodynamic variables.


METHODS
Umbilical cord hs-CRP concentrations were obtained in 38 neonates. In the same subjects aged 3-5 years, aIMT and cIMT were measured by high-resolution ultrasound scan, in the dorsal arterial wall. Anthropometric variables and BPs were obtained for each child.


RESULTS
Maximum (median 0.700 mm, range 0.500-1.080 vs 0.650 mm, 0.400-0.860; p = 0.32) aIMTs were similar between children who were born SGA (n = 17) and AGA (n = 21), respectively. Concentrations of hs-CRP were not correlated with IMTs. In children who were born SGA, systolic BP was significantly correlated with umbilical cord hs-CRP concentrations (r = 0.60; p = 0.009).


CONCLUSIONS
Children who were born SGA have a higher, although not significant, aortic thickening than those who were born AGA. Umbilical cord hs-CRP concentrations do not seem to be involved in this process. Instead, hs-CRP concentrations were significantly related to systolic BP values in children who were born SGA, suggesting that hs-CRP at birth could be associated with sympathetic system hyperactivity and with the stress response during childhood.
Pediatric Department, Medical School, University of Padua, Azienda Ospedaliera-Padova, Via Giustiniani, 3, 35128 Padua, Italy. trevo@pediatria.unipd.it
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Zanardo
D000886:Anthropometry / Q000379:methods; D001012:Aorta, Abdominal / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight / Q000502:physiology; D002097:C-Reactive Protein / Q000032:analysis*; D002339:Carotid Arteries / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D002675:Child, Preschool; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D017539:Tunica Intima / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014470:Umbilical Cord / Q000737:chemistry*
D015415:Biomarkers; D002097:C-Reactive Protein