Suciu Laura Mihaela, Giesinger Regan E, Mărginean Claudiu, Muntean Mihai, Cucerea Manuela, Făgărășan Amalia, McNamara Patrick
Department of Pediatrics, University of Medicine Pharmacy Science and Technology George Emil Palade of Târgu Mureș, Târgu Mureș, Romania.
Division of Neonatology, Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa, IA, United States.
Front Pediatr. 2023 Jan 16;10:1045242. doi: 10.3389/fped.2022.1045242. eCollection 2022.
To study changes in heart function and hemodynamics during the transitional period in small for gestational (SGA) infants and appropriate (AGA) healthier counterparts.
A hospital based prospective observational study was performed at a perinatal center. Echocardiograms were performed on the first postnatal day and again at 48 h age. Term SGA infants were compared with those AGA newborns matched for the GA and mode of delivery.
Eighteen SGA infants were compared with 18 AGA infants [gestation 38 ± 1.5 vs. 38 ± 1.2 weeks, > 0.05 and birthweight 2331 ± 345 vs. 3332 ± 405 grams, < 0.05, respectively]. Maternal weight and body mass index was higher among non-affected pregnancies, 61% infants were born vaginally, and no differences in cord blood pH at birth were noted. SGA infants had higher systolic and mean blood pressure at both time points, lower indices of right ventricular (RV) performance [TAPSE (tricuspid annular peak systolic excursion) 7.4 ± 2.8 vs. 9.3 ± 0.7 on day 1, 7.2 ± 2.8 vs. 9.2 ± 0.5 on day 2, = 0.001], lower pulmonary acceleration time (PAAT) suggestive of elevated pulmonary vascular resistance [56.4 ± 10.5 vs. 65.7 ± 13.2 on day 1, 61.4 ± 12.5 vs. 71.5 ± 15.7 on day 2, = 0.01] and higher left ventricular (LV) ejection fraction [62.1 ± 7.8 vs. 54.9 ± 5.5 on day 1, 61.9 ± 7.6 vs. 55.8 ± 4.9 on day 2, = 0.003].
SGA infants had evidence of higher pulmonary vascular resistance, and lower RV performance during the postnatal transition. The relevance and impact of these changes to hemodynamic disease states during the postnatal transition requires prospective investigation.
研究小于胎龄儿（SGA）和与之匹配的出生体重正常的健康对照儿（AGA）在过渡期心脏功能和血流动力学的变化。
在一家围产期中心进行了一项基于医院的前瞻性观察性研究。出生后第1天和48小时分别进行超声心动图检查。将足月SGA婴儿与根据孕周和分娩方式匹配的AGA新生儿进行比较。
18例SGA婴儿与18例AGA婴儿进行比较[孕周分别为38±1.5周和38±1.2周，P>0.05；出生体重分别为2331±345克和3332±405克，P<0.05]。未受影响的妊娠孕妇体重和体重指数较高，61%的婴儿经阴道分娩，出生时脐血pH值无差异。SGA婴儿在两个时间点的收缩压和平均血压均较高，右心室（RV）功能指标较低[TAPSE（三尖瓣环收缩期峰值位移）第1天为7.4±2.8 vs. 9.3±0.7，第2天为7.2±2.8 vs. 9.2±0.5，P=0.001]，肺加速时间（PAAT）较低提示肺血管阻力升高[第1天为56.4±10.5 vs. 65.7±13.2，第2天为61.4±12.5 vs. 71.5±15.7，P=0.01]，左心室（LV）射血分数较高[第1天为62.1±7.8 vs. 54.9±5.5，第2天为61.9±7.8 vs. 55.8±4.9，P=0.003]。
SGA婴儿在出生后过渡期有肺血管阻力升高和右心室功能降低的证据。这些变化在出生后过渡期对血流动力学疾病状态的相关性和影响需要前瞻性研究。
