title: Placental vascular dysfunction, fetal and childhood growth, and cardiovascular development: the generation R study.
abstract: BACKGROUND
  Suboptimal fetal nutrition may influence early growth and cardiovascular development. We examined whether umbilical and uterine artery resistance indices, as measures of feto-placental and utero-placental vascular function, respectively, are associated with fetal and childhood growth and cardiovascular development.
  
  
  RESULTS
  This study was embedded in a population-based prospective cohort study among 6716 mothers and their children. Umbilical artery pulsatility index and uterine artery resistance index and fetal growth were measured in third trimester. Childhood growth was repeatedly assessed from birth to the age of 6 years. We measured body fat distribution, left ventricular mass, and blood pressure at the age of 6 years. Higher third trimester umbilical and uterine artery vascular resistance were associated with lower fetal length and weight growth in third trimester resulting in a smaller size at birth among boys and girls (P values < 0.05). These differences in length and weight growth became smaller from the age of 6 months onwards, but were still present at the age of 6 years. Higher third trimester umbilical artery vascular resistance, but not uterine artery vascular resistance, was associated with higher childhood body mass index, total fat mass, android/gynoid fat mass ratio, and systolic blood pressure, and with a lower left ventricular mass (P values<0.05). These associations were not explained by birth weight. Stronger associations tended to be present among girls as compared with boys.
  
  
  CONCLUSIONS
  Higher third trimester feto-placental vascular resistance, but not utero-placental vascular resistance, was associated with slower fetal growth rates and cardiovascular adaptations in childhood.
authors.affiliation: Generation R Study Group (R.G., V.W.V.J.) and the Departments of Epidemiology (R.G., H.T., A.H., V.W.V.J.), Paediatrics (R.G., V.W.V.J.), Obstetrics and Gynaecology (E.A.P.S.), and Child and Adolescent Psychiatry (H.T.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Romy
authors.initials: R
authors.lastname: Gaillard
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D002319:Cardiovascular System / Q000196:embryology / Q000254:growth & development*; D002648:Child; D002657:Child Development / Q000502:physiology*; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010920:Placenta / Q000098:blood supply* / Q000503:physiopathology*; D010922:Placenta Diseases / Q000453:epidemiology / Q000503:physiopathology*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D014469:Umbilical Arteries / Q000503:physiopathology; D014599:Uterus / Q000098:blood supply / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology; D055815:Young Adult
keywords: blood supply; cardiovascular diseases; epidemiology; pediatrics; pregnancy