Intrauterine Growth Restriction (IUGR) Induces Signs of Subclinical Atherosclerosis in 6-Year-Old Infants Despite Absence Of Excessive Growth

Author:

Tzschoppe Anja1,von Kries Rüdiger2,Struwe Ellen3,Rascher Wolfgang1,Dörr Helmuth-Guenther1,Jüngert Jörg1,Rauh Manfred1,Beckmann Matthias4,Schild Ralf5,Goecke Tamme6,Dötsch Jörg7

Affiliation:

1. Department of Paediatrics and Adolescent Medicine, University of Erlangen-Nuremberg, Erlangen, Germany

2. Institute of Social Paediatrics and Adolescent Medicine, University of Munich, München Germany

3. Regional Centre for Social Paediatrics, Klinikum Konstanz, Konstanz, Germany

4. Department of Obstetrics and Gynaecology, University of Erlangen-Nuremberg, Erlangen , Germany

5. Department of Obstetrics and Gynaecology, DIAKOVERE gGmbH, Hannover, Germany

6. Department of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany

7. Department of Paediatrics and Adolescent Medicine University of Cologne, Köln, Germany

Abstract

Abstract Background Postnatal catch-up growth and rapid weight gain after intrauterine growth restriction (IUGR) seem to increase the risk for later disease. This study aimed to compare features of the metabolic syndrome early in life between IUGR and appropriate for gestational age (AGA) infants. Patients Data for 9 infants with IUGR defined by a birth weight<10th percentile and ultrasound-proven placental insufficiency and 11 AGA children were available. Method Postnatal growth, auxological, cardiovascular, and metabolic parameters up to a chronological age of 6 years were assessed: Fasting serum concentrations of LDL-cholesterol, insulin, leptin, IGF-I, DHEAS, skinfold thicknesses, blood pressure, and mean carotid intima-media thickness (cIMT). Results All IUGR infants showed catch-up growth, although mean BMI SDS and total subcutaneous fat mass at the age of 6 years were still slightly lower compared to the AGA cohort. Reduced serum leptin concentrations were observed in IUGR infants (p=0.02), whereas no significant difference was found for IGF-I, insulin, LDL-cholesterol and DHEAS concentrations. Mean cIMT was significantly higher in IUGR infants (p<0.05). Mean arterial pressure did no differ. Discussion and Conclusion In 6-year-old IUGR infants with catch-up growth, who still had a slightly reduced BMI SDS compared to the AGA group, signs of subclinical atherosclerosis were detectable suggesting that cardiovascular risk in IUGR may be present even in the absence of excessive growth.

Publisher

Georg Thieme Verlag KG

Subject

Pediatrics, Perinatology and Child Health

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