Crispi Fatima, Crovetto Francesca, Gratacos Eduard
Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), ICGON, IDIBAPS, University of Barcelona, Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
Early Hum Dev. 2018 Nov;126:23-27. doi: 10.1016/j.earlhumdev.2018.08.013. Epub 2018 Sep 8.
Intrauterine growth restriction is one of the most common obstetric conditions, affecting 7-10% of fetuses. Affected fetuses are actually exposed in utero to an adverse environment during the highly critical time of development and may face life-long health consequences such as increased cardiovascular risk in adulthood. Already in utero, fetuses affected by growth restriction show remodeled hearts with signs of systolic and diastolic dysfunction. Cardiovascular remodeling persist into postnatal life, from the neonatal period to adolescence, suggesting a primary fetal cardiac programming that might explain the increased cardiovascular risk later in life. In this review we summarize the current evidence on fetal cardiovascular programming in fetuses affected by growth restriction, its consequences later and possible strategies from which they could benefit to reduce their cardiovascular risk.
胎儿生长受限是最常见的产科情况之一，影响7%至10%的胎儿。受影响的胎儿在发育的关键时期实际上在子宫内就暴露于不利环境中，可能面临终身健康后果，如成年后患心血管疾病的风险增加。在子宫内时，受生长受限影响的胎儿就已表现出心脏重塑，伴有收缩和舒张功能障碍的迹象。心血管重塑会持续到出生后，从新生儿期到青春期，这表明存在一种原发性胎儿心脏编程，这可能解释了日后患心血管疾病风险增加的原因。在本综述中，我们总结了目前关于生长受限胎儿心血管编程的证据、其后期后果以及他们可能受益的降低心血管风险的潜在策略。
