Department of Pediatrics, Department of Gynecological Science and Human Reproduction, Division of Maternal Fetal Medicine, University of Padua School of Medicine, Via Guistiniani 3, Padua, Italy.
Hypertens Res. 2013 May;36(5):440-3. doi: 10.1038/hr.2012.219. Epub 2013 Jan 31.
Fetuses with intrauterine growth restriction (IUGR) have significant aortic intima-media thickening (aIMT), which suggests that preclinical atherosclerosis might predispose the infants to hypertension. However, the natural course of aIMT in babies with IUGR remains an open question.The study enrolled 77 pregnant women between January 2007 and August 2009. The fetuses were classified as AGA (appropriate for gestational age) or IUGR, if the estimated fetal weight was between the 10th and 90th percentile or below the 10th percentile (with umbilical artery pulsatility index (PI) >2s.d.), respectively. Anthropometric parameters and aIMT were detected in each IUGR and AGA fetus at a mean gestational age of 32 weeks. The follow-up was performed in 25 IUGR and 25 AGA infants at a mean postnatal age of 18 months; the previous measurements were repeated, and blood pressure measurements were taken. The maximum aIMT was significantly higher in the IUGR fetuses and infants compared with the AGA infants, both in utero (2.05±0.43 vs. 1.05±0.19 mm, P<0.001) and at the follow-up (2.3±0.8 vs. 1.06±0.18 mm, P<0.0001), the resulting values significantly correlated (P=0.018) with one another. The systolic blood pressure was significantly increased in the IUGR subjects (123±16 vs. 104±8.5 mm Hg, P<0.0004), and it correlated with the prenatal and postnatal aIMT values (P<0.0156 and P<0.0054, respectively). The aortic wall thickening progression in IUGR fetuses and infants differed from AGA, which may predispose the infants to hypertension early in life and cardiovascular risk later in life.
胎儿宫内生长受限（IUGR）有明显的主动脉内膜-中层增厚（aIMT），这表明临床前动脉粥样硬化可能使婴儿易患高血压。然而，IUGR 婴儿的 aIMT 自然病程仍然是一个悬而未决的问题。
该研究纳入了 2007 年 1 月至 2009 年 8 月间的 77 名孕妇。胎儿被分为 AGA（胎龄适当）或 IUGR，如果估计胎儿体重在第 10 至 90 百分位之间或低于第 10 百分位（脐动脉搏动指数（PI）>2s.d.）。在平均孕龄 32 周时，对每个 IUGR 和 AGA 胎儿进行了人体测量参数和 aIMT 的检测。在平均产后 18 个月时，对 25 名 IUGR 和 25 名 AGA 婴儿进行了随访；重复了之前的测量，并进行了血压测量。与 AGA 婴儿相比，IUGR 胎儿和婴儿的 aIMT 最大值明显更高，无论是在宫内（2.05±0.43 与 1.05±0.19mm，P<0.001）还是在随访时（2.3±0.8 与 1.06±0.18mm，P<0.0001），两者之间存在显著相关性（P=0.018）。IUGR 受试者的收缩压明显升高（123±16 与 104±8.5mmHg，P<0.0004），且与产前和产后的 aIMT 值相关（P<0.0156 和 P<0.0054）。IUGR 胎儿和婴儿的主动脉壁增厚进展不同于 AGA，这可能使婴儿在生命早期易患高血压，并在以后的生活中面临心血管风险。
