OP31.02: Aortic intima media thickness in twin pregnancies affected by selective intrauterine growth restricted and small for gestational age co-twin

Abstract Intrauterine undernutrition may lead to fetal vascular programming. We compared abdominal aortic intima-media thickness (aIMT) and aortic diameter (aD) between appropriate for gestational age (AGA) and growth-restricted fetuses (GRF). We recruited 136 singleton fetuses at 34–37 weeks of gestation from Fetal Medicine Unit of Aga Khan University Hospital, Karachi (January–November 2017). Subjects were classified as AGA (n = 102) and GRF (n = 34) using INTER-GROWTH 21st growth reference and standard ultrasound protocol. Their far- and near-wall aIMT and aD were compared after adjustment of maternal age, first-trimester body mass index, fetal gender, hypertension and hyperglycemia in pregnancy. As the severity of growth restriction increased in GRF, aIMT and aD showed an increasing and a decreasing trend, respectively. Both far- and near-wall aIMT in GRF [(adj. β = 0.082, 95% confidence interval [CI] 0.042–0.123) and (adj. β = 0.049, 95% CI 0.010–0.089)] were significantly greater with reference to AGA fetuses. GRF subgroup analysis into small for gestational age (SGA) fetuses and intrauterine growth restricted (IUGR) revealed highly significant difference between AGA and IUGR for far (0.142 mm, P-value < 0.001) and near-wall aIMT (0.115 mm, P-value < 0.001) and marginally significant aD difference (0.51 mm, P-value 0.05). These findings suggest that the extent of fetal aortic remodelling is influenced by the severity of growth restriction. Hence, the targeted interventions for the cardiovascular health promotion of IUGR and SGA born neonates are desirable during early childhood, particularly in set ups with high prevalence of low birth weight babies.

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Relationship between small for gestational age and aortic intima-media thickness in newborns

Paediatrica Indonesiana ◽

10.14238/pi54.1.2014.57-61 ◽

2014 ◽

Vol 54 (1) ◽

pp. 57 ◽

Cited By ~ 2

Author(s):

Ahmad Bayu Alfarizi ◽

Ria Nova ◽

Julniar Mawardi Tasli ◽

Theodorus Theodorus

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Intima Media Thickness ◽

Control Group ◽

Case Group ◽

Media Thickness ◽

And Control ◽

Aortic Intima ◽

The Relationship ◽

Control Study

Background Small for gestational age (SGA) has been associatedwith adult cardiovascular disease. Small for gestational agenewborns may undergo early aortic wall intima-media thickening(aIMT) in utero.Objective To determine the relationship between SGA as a riskfactor for increased aIMT, as a sign of atherosclerosis onset.Methods We conducted a case-control study in the Neonatal Wardand Rooming-in Nursery at Dr. Mohammad Hoesin Hospital,Palembang, between April to June 2012. Subjects were allocatedto either the case group (aIMT 2: 0.9 mm) or to the controlgroup (aIMT <0.9 mm). Newborns were classified as SGA iftheir birthweight (BW) was < l O'h percentile, and appropriatefor gestational age (AGA) if their BW was between lQth - 90'hpercentile, according to the Lubchenco curve. Abdominal aorticintima-media thickness was measured by echocardiographyexamination.Results The case and control groups consisted of 30 n ewbornseach. The proportion of SGA newborns was higher in the casegroup than the control group. The likelihood of infants in the casegroup being SGA was significantly higher compared to the controlgroup, with odds ratio of 10.8 (95%CI 3,26 to 35, 72) . The meanaIMT was significantly higher in SGA than in AGA infants, 0.9(SD 0.16) mm vs. 0.8 (SD 0.13) mm, respectively, with a meandifference of 0, 13 (9 5% CI 0, 050 to 0,209 mm; P"" 0,02).Conclusion Increased aIMT is more likely found in SGA newborns.

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