title: Cardiovascular function in children born very preterm after intrauterine growth restriction with severely abnormal umbilical artery blood flow.
abstract: OBJECTIVE
  Low birthweight has been linked to increased cardiovascular risk in adulthood. We evaluated the effect on cardiovascular outcome of intrauterine growth restriction (IUGR) with abnormal fetal blood flow in children born very preterm.
  
  
  METHODS
  Blood pressure, cardiac function and size, diameters, distensibility, and stiffness of the abdominal aorta, carotid, and popliteal arteries, and endothelial function were assessed non-invasively in 7-year-old children (n = 32) born very preterm with IUGR, with birthweight (median, range) 650 g (395-976 g) and gestational age 27 weeks (24-29 weeks). In addition, intima-media thickness was measured in the carotid artery. Controls were matched for gender and age and had birthweight appropriate-for-gestational-age (AGA). The study included 32 preterm-AGA children with birthweight 1010 g (660-1790) g and 32 term-AGA children with birthweight 3530 g (3000-4390) g.
  
  
  RESULTS
  Preterm-IUGR children had lower microvascular response to acetylcholine, lower aortic stiffness, and higher distensibility compared with the preterm-AGA group (p = 0.019, p = 0.001, and p < 0.001, respectively) and lower carotid intima-media thickness compared with the term-AGA group (p = 0.047). The highest aortic β and lowest distensibility were found in the preterm-AGA group. Height-adjusted systolic blood pressure was higher in the preterm groups than in the term-AGA group (p = 0.018). Cardiac function and size did not differ between the groups.
  
  
  CONCLUSIONS
  IUGR and preterm birth appear to be associated with structural changes in the arterial wall, whereas preterm birth seems to be associated with higher blood pressure. Using conventional echocardiography, we observed no effect of IUGR on cardiac size and function.
authors.affiliation: Lund University, Lund, Sweden eva.morsing@med.lu.se.
authors.forename: Eva
authors.initials: E
authors.lastname: Morsing
authors.affiliation: Lund University, Lund, Sweden.
authors.forename: Petru
authors.initials: P
authors.lastname: Liuba
authors.affiliation: Lund University, Lund, Sweden.
authors.forename: Vineta
authors.initials: V
authors.lastname: Fellman
authors.affiliation: Lund University, Lund, Sweden.
authors.forename: Karel
authors.initials: K
authors.lastname: Maršál
authors.affiliation: Lund University, Lund, Sweden.
authors.forename: Jana
authors.initials: J
authors.lastname: Brodszki
mesh_terms: D000367:Age Factors; D062186:Arterial Pressure; D001158:Arteries / Q000503:physiopathology*; D001724:Birth Weight; D001783:Blood Flow Velocity; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002657:Child Development; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000503:physiopathology*; D005865:Gestational Age; D006321:Heart / Q000503:physiopathology*; D006334:Heart Function Tests; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D012039:Regional Blood Flow; D012307:Risk Factors; D014469:Umbilical Arteries / Q000503:physiopathology*
keywords: Blood pressure; cardiovascular function; intima-media thickness; intrauterine growth restriction; preterm birth