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胎儿生长受限和早产对婴儿期心脏形态和功能的影响。

Effects of foetal growth restriction and preterm birth on cardiac morphology and function during infancy.

机构信息

The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics, Monash University, Melbourne, Vic., Australia.

Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.

出版信息

Acta Paediatr. 2018 Mar;107(3):450-455. doi: 10.1111/apa.14144. Epub 2017 Nov 22.

Abstract

AIM

To investigate the effects of foetal growth restriction (FGR) and prematurity on cardiac morphology and function in infancy. We hypothesised that FGR and prematurity would both alter cardiac development.

METHODS

Cardiac morphology and function were evaluated in 24 preterm FGR infants (p-FGR) and 23 preterm and 19 term appropriately grown for gestational age infants (p-AGA and t-AGA, respectively) by conventional echocardiography and Tissue Doppler Imaging. p-FGR and p-AGA infants were studied on postnatal day 1 and all groups were studied at one-and six-months post-term age.

RESULTS

p-FGR infants demonstrated increased cardiac sphericity compared to AGA peers on postnatal day 1 (p = 0.004) and at one-month post-term age (p = 0.004). Posterior and relative wall thickness increased overtime in the p-FGR group only (p < 0.05). Systolic function was not different between groups. E/e' ratio was higher in both preterm groups compared to the term group at one-month post-term age (p = 0.01). No statistically significant group differences were found at six-months post-term age.

CONCLUSION

Foetal growth restriction was associated with subtle cardiac morphological changes, whereas both prematurity and FGR were associated with subclinical alterations in diastolic function.

摘要

目的

研究胎儿生长受限(FGR)和早产对婴儿期心脏形态和功能的影响。我们假设 FGR 和早产都会改变心脏发育。

方法

通过常规超声心动图和组织多普勒成像评估 24 例早产 FGR 婴儿(p-FGR)和 23 例早产和 19 例胎龄适当的足月生长婴儿(p-AGA 和 t-AGA)的心脏形态和功能。p-FGR 和 p-AGA 婴儿在出生后第 1 天进行研究,所有组均在胎龄后 1 个月和 6 个月进行研究。

结果

p-FGR 婴儿在出生后第 1 天(p=0.004)和胎龄后 1 个月(p=0.004)时,心脏球形度较 AGA 同龄人增加。后壁和相对壁厚度仅在 p-FGR 组随时间增加(p<0.05)。收缩功能在各组间无差异。在胎龄后 1 个月,两个早产儿组的 E/e' 比值均高于足月组(p=0.01)。在胎龄后 6 个月时,未发现统计学上显著的组间差异。

结论

胎儿生长受限与心脏形态的细微变化有关,而早产和 FGR 均与舒张功能的亚临床改变有关。

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