title: Intrauterine growth restriction is associated with structural alterations in human umbilical cord and decreased nitric oxide-induced relaxation of umbilical vein.
abstract: BACKGROUND
  Intrauterine growth restriction (IUGR) affects ∼8% of all pregnancies and is associated with major perinatal mortality and morbidity, and with an increased risk to develop cardiovascular diseases in adulthood. Despite identification of several risk factors, the mechanisms implicated in the development of IUGR remain poorly understood. In case of placental insufficiency, reduced delivery of oxygen and/or nutrients to the fetus could be associated with alterations in the umbilical circulation, contributing further to the impairment of maternal-fetal exchanges. We compared the structural and functional properties of umbilical cords from growth-restricted and appropriate for gestational age (AGA) term newborns, with particular attention to the umbilical vein (UV).
  
  
  METHODS
  Human umbilical cords were collected at delivery. Morphological changes were investigated by histomorphometry, and UV's reactivity by pharmacological studies.
  
  
  RESULTS
  Growth-restricted newborns displayed significantly lower growth parameters, placental weight and umbilical cord diameter than AGA controls. Total cross-section and smooth muscle areas were significantly smaller in UV of growth-restricted neonates than in controls. Maximal vasoconstriction achieved in isolated UV was lower in growth-restricted boys than in controls, whereas nitric oxide-induced relaxation was significantly reduced in UV of growth-restricted girls compared to controls.
  
  
  CONCLUSIONS
  IUGR is associated with structural alterations of the UV in both genders, and with a decreased nitric oxide-induced relaxation in UV of newborn girls, whereas boys display impaired vasoconstriction. Further investigations will allow to better understand the regulation of umbilical circulation in growth-restricted neonates, which could contribute to devise potential novel therapeutic strategies to prevent or limit the development of IUGR.
authors.affiliation: Neonatal Research Laboratory, Clinic of Neonatology, Department of Pediatrics, Lausanne University Hospital, 1011 Lausanne, Switzerland. Electronic address: Anne-Christine.Peyter@chuv.ch.
authors.forename: A-C
authors.initials: AC
authors.lastname: Peyter
authors.affiliation: Neonatal Research Laboratory, Clinic of Neonatology, Department of Pediatrics, Lausanne University Hospital, 1011 Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Delhaes
authors.affiliation: Department of Gynecology and Obstetrics, Lausanne University Hospital, 1011 Lausanne, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Baud
authors.affiliation: Department of Gynecology and Obstetrics, Lausanne University Hospital, 1011 Lausanne, Switzerland.
authors.forename: Y
authors.initials: Y
authors.lastname: Vial
authors.affiliation: Neonatal Research Laboratory, Clinic of Neonatology, Department of Pediatrics, Lausanne University Hospital, 1011 Lausanne, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Diaceri
authors.affiliation: Neonatal Research Laboratory, Clinic of Neonatology, Department of Pediatrics, Lausanne University Hospital, 1011 Lausanne, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Menétrey
authors.affiliation: Department of Gynecology and Obstetrics, Lausanne University Hospital, 1011 Lausanne, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Hohlfeld
authors.affiliation: Neonatal Research Laboratory, Clinic of Neonatology, Department of Pediatrics, Lausanne University Hospital, 1011 Lausanne, Switzerland.
authors.forename: J-F
authors.initials: JF
authors.lastname: Tolsa
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009569:Nitric Oxide; D011247:Pregnancy; D014471:Umbilical Veins / Q000473:pathology*; D014664:Vasodilation
chemical_list: D009569:Nitric Oxide
keywords: Human umbilical vein; Intrauterine growth restriction; Morphometry; Nitric oxide; Umbilical cord; Vasodilatation