Aortic intima media thickness in fetuses and children with intrauterine growth restriction.
OBJECTIVE
To measure aortic intima media thickness and diameter by ultrasonography in fetuses with intrauterine growth restriction (IUGR) and in appropriate for gestational age (AGA) fetuses and in the same children after a mean follow-up of 18 months.


METHODS
This was a prospective study performed between January 2006 and August 2008. Fetuses were classified as having IUGR if the estimated fetal weight was below the 10th percentile and umbilical artery pulsatility index was greater than 2 standard deviations; they were classified as AGA if the estimated fetal weight was between the 10th and 90th percentiles. Abdominal aortic intima media thickness and diameter were measured in each fetus with IUGR and in each AGA fetus at a mean gestational age of 32 weeks. The same measurements were taken in the children after a mean follow-up of 18 months.


RESULTS
Thirty-eight fetuses with IUGR and 32 AGA fetuses were enrolled in the study. Aortic intima media thickness median values were significantly higher in IUGR than in AGA both in utero (1.9 mm compared with 1.15 mm; P<.001) and after birth (2.4 mm compared with 1.03 mm; P<.001) and were significantly correlated (P=.018, r=0.48). At 32 weeks of gestation, aortic intima media thickness in fetuses with IUGR was inversely correlated with estimated fetal weight (P<.003; r=-0.58). Median diameter of the abdominal aorta and blood-flow velocity at 32 weeks of gestation were significantly higher in fetuses with IUGR compared with AGA fetuses (median diameter 4.5 mm compared with 3.6 mm, P<.001, blood-flow velocity 42.5 cm/s compared with 23.3 cm/s, P<.001). At follow-up, in 25 children who had had IUGR and 25 children who had been AGA, there was no significant difference in median diameter of the abdominal aorta (6.8 mm compared with 7.5 mm, P=.21).


CONCLUSIONS
Aortic wall thickening in fetuses and children with IUGR shows differences with respect to those who were AGA. This may reflect a correlation between impaired growth in utero, Doppler abnormalities, low birth weight, and early signs of vascular dysfunction.


METHODS
II.
Cosmi
Erich
E
From Gynecological Science and Human Reproduction, Section of Maternal Fetal Medicine, University of Padua School of Medicine, Padua, Italy; Pharmacology and Physiology, the University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey; and Pediatrics, University of Padua School of Medicine, Padua, Italy.
Visentin
Silvia
S
Fanelli
Tiziana
T
Mautone
Alan J
AJ
Zanardo
Vincenzo
V
D000328:Adult; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000196:embryology*; D001783:Blood Flow Velocity; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D020567:Fetal Weight; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000196:embryology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000196:embryology*; D016216:Ultrasonography, Prenatal