title: Feasibility of neonatal pulse wave velocity and association with maternal hemoglobin A1c.
abstract: BACKGROUND
  Use of non-invasive peripheral arterial tonometry to assess arterial stiffness has not been studied in neonates. Perinatal factors impact childhood vascular health, but the effect in neonates remains to be examined.
  
  
  OBJECTIVE
  To examine the feasibility of pulse wave velocity (PWV) among healthy term neonates, and to evaluate the effects of perinatal factors on neonatal PWV.
  
  
  METHODS
  Pregnant women with singleton gestation presenting for routine care were enrolled. Postnatally, PWV measurements of their neonates were obtained using an arterial tonometer. A variability index was calculated for each PWV measurement. Intra- and inter-observer reproducibility were illustrated with Bland-Altman plots. Medical records were reviewed. Relationships between neonatal PWV and perinatal factors were examined.
  
  
  RESULTS
  PWV measurements were attempted in 76 neonates and successfully obtained in 67 (88%). Using PWV measurements with a variability index ≤ 0.25 (48 neonates), the intra-class coefficient was 0.69. The mean differences (limits of agreement) for intra- and inter-rater reproducibility were 0.02 (-3.64 to 3.60) and 0.34 (-2.23 to 2.39), respectively. Median neonatal PWV was 2.80 m/s (range 0.60-8.40). Neonates of mothers with HgbA1c ≥6% had significantly higher PWV than neonates of mothers with HgbA1c <6% (4.12 m/s, 95% CI 3.22-5.02, vs. 2.78 m/s, 95% CI 2.28-3.28, p = 0.02).
  
  
  CONCLUSIONS
  Neonatal PWV using peripheral arterial tonometry is feasible and reproducible when using measurements with a variability index ≤ 0.25. Neonates of mothers with increased HgbA1c had higher PWV, suggesting an effect of maternal hyperglycemia on neonatal vasculature. The long-term implications of this finding warrant further investigation.
authors.affiliation: Pediatric Cardiology, Lucile Packard Children's Hospital at Stanford University, Palo Alto, Calif., USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Chen
authors.forename: Shilpa
authors.initials: S
authors.lastname: Chetty
authors.forename: Alexander
authors.initials: A
authors.lastname: Lowenthal
authors.forename: Jasmine M
authors.initials: JM
authors.lastname: Evans
authors.forename: Chau
authors.initials: C
authors.lastname: Vu
authors.forename: Katie J
authors.initials: KJ
authors.lastname: Stauffer
authors.forename: Deirdre
authors.initials: D
authors.lastname: Lyell
authors.forename: Elif Seda
authors.initials: ES
authors.lastname: Selamet Tierney
mesh_terms: D000328:Adult; D001158:Arteries / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D000068104:Infant Health; D007231:Infant, Newborn; D008365:Manometry / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D011297:Prenatal Exposure Delayed Effects; D063177:Pulse Wave Analysis / Q000379:methods*; D013223:Statistics as Topic; D059289:Vascular Stiffness
chemical_list: D006442:Glycated Hemoglobin