title: [Perinatal outcome and cardiac dysfunction in preterm growth-restricted neonates in relation to placental impairment severity].
abstract: BACKGROUND
  Intrauterine growth restriction (IUGR) and prematurity have been associated with increased perinatal morbidity and mortality and also with cardiovascular foetal programming. However, there are few studies on the impact of placenta-related IUGR on perinatal outcomes and cardiovascular biomarkers in pre-term infants.
  
  
  OBJECTIVE
  To determine differences in neonatal morbidity, mortality and cord blood biomarkers of cardiovascular dysfunction between pre-term placenta-related IUGR and non-IUGR new-borns, and to analyse their relationship with the severity of IUGR according to foetal Doppler evaluation.
  
  
  METHODS
  Prospective cohort study: pre-term infants with placenta-related IUGR and matched pre-term infants without IUGR. A Doppler scan was performed, and placenta-IUGR was classified according to severity. Comparative analysis of perinatal outcomes, neonatal morbidity and mortality, and cord blood levels of biomarkers of cardiovascular dysfunction was performed.
  
  
  RESULTS
  IUGR new-borns present lower weight, length, head circumference, and Apgar score at birth, as well as increased neonatal and cardiovascular dysfunction biomarker levels, compared with pre-term new-borns without IUGR. These differences increase with the severity of IUGR determined by prenatal umbilical artery Doppler scan.
  
  
  CONCLUSIONS
  Placenta-related-IUGR pre-term infants, irrespective of gestational age, present increased neonatal morbidity and mortality that is significantly proportional to the severity of IUGR. Placental impairment and severity also determine levels of cardiovascular dysfunction biomarkers at birth.
authors.affiliation: Fundación Institut de Recerca de la Vall d'Hebron (VHIR), Barcelona, España. Electronic address: julicpvs@hotmail.com.
authors.forename: Júlia
authors.initials: J
authors.lastname: Candel Pau
authors.affiliation: Servicio de Neonatología, Hospital Universitario Vall d'Hebron, Barcelona, España; Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Félix
authors.initials: F
authors.lastname: Castillo Salinas
authors.affiliation: Servicio de Neonatología, Hospital Universitario Vall d'Hebron, Barcelona, España; Red de Salud Materno Infantil y del Desarrollo (RED SAMID), Barcelona, España.
authors.forename: Josep
authors.initials: J
authors.lastname: Perapoch López
authors.affiliation: Servicio de Pediatría y Endocrinología Pediátrica, Hospital Universitario Vall d'Hebron, Barcelona, España; Universidad Autónoma de Barcelona, Barcelona, España; CIBERER, Barcelona, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carrascosa Lezcano
authors.affiliation: Fundación Institut de Recerca de la Vall d'Hebron (VHIR), Barcelona, España; Red de Salud Materno Infantil y del Desarrollo (RED SAMID), Barcelona, España.
authors.forename: Olga
authors.initials: O
authors.lastname: Sánchez García
authors.affiliation: Servicio de Obstetricia y Ginecología, Hospital Universitario Vall d'Hebron, Barcelona, España; Red de Salud Materno Infantil y del Desarrollo (RED SAMID), Barcelona, España; Universidad Autónoma de Barcelona, Barcelona, España.
authors.forename: Elisa
authors.initials: E
authors.lastname: Llurba Olivé
mesh_terms: D005260:Female; D005317:Fetal Growth Retardation; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010927:Placental Insufficiency; D011247:Pregnancy; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: Biomarcadores cardiovasculares; Cardiovascular biomarkers; Doppler fetal; Fetal Doppler; Intrauterine growth restriction; Morbilidad neonatal; Neonatal morbidity; Prematuridad; Prematurity; Restricción del crecimiento intrauterino