title: Effects of intrauterine growth restriction on sleep and the cardiovascular system: The use of melatonin as a potential therapy?
abstract: Intrauterine growth restriction (IUGR) complicates 5-10% of pregnancies and is associated with increased risk of preterm birth, mortality and neurodevelopmental delay. The development of sleep and cardiovascular control are closely coupled and IUGR is known to alter this development. In the long-term, IUGR is associated with altered sleep and an increased risk of hypertension in adulthood. Melatonin plays an important role in the sleep-wake cycle. Experimental animal studies have shown that melatonin therapy has neuroprotective and cardioprotective effects in the IUGR fetus. Consequently, clinical trials are currently underway to assess the short and long term effects of antenatal melatonin therapy in IUGR pregnancies. Given melatonin's role in sleep regulation, this hormone could affect the developing infants' sleep-wake cycle and cardiovascular function after birth. In this review, we will 1) examine the role of melatonin as a therapy for IUGR pregnancies and the potential implications on sleep and the cardiovascular system; 2) examine the development of sleep-wake cycle in fetal and neonatal life; 3) discuss the development of cardiovascular control during sleep; 4) discuss the effect of IUGR on sleep and the cardiovascular system and 5) discuss the future implications of melatonin therapy in IUGR pregnancies.
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia. Electronic address: stephanie.yiallourou@monash.edu.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Yiallourou
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.
authors.forename: Euan M
authors.initials: EM
authors.lastname: Wallace
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Miller
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia.
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
mesh_terms: D000975:Antioxidants / Q000627:therapeutic use; D002319:Cardiovascular System / Q000187:drug effects*; D002657:Child Development; D005317:Fetal Growth Retardation / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008550:Melatonin / Q000494:pharmacology* / Q000627:therapeutic use; D047928:Premature Birth; D012890:Sleep / Q000187:drug effects*
chemical_list: D000975:Antioxidants; D008550:Melatonin
keywords: Cardiovascular control; Intrauterine growth restriction; Melatonin; Preterm birth; Sleep