307 Disturbed Cardiac Functional Parameters and Blood Flow Parameters of Peripheral Arteries in Premature Sga Neonates

Abstract

Top of pageAbstract Problem: Small for gestational age preterm neonates (SGA) are at higher risk for early postnatal morbidity and cardiovascular and metabolic diseases in later childhood. The aim of the prospective study was to determine the cardiac adaptation and the organ blood flow in growth retarded neonates after intrauterine hemodynamic disturbances in comparison to appropriate for gestational age preterm infants (AGA). Patients and methods: 25 AGA neonates (29.1 ± 1.4 wks, 1420 ± 243 g) and 25 small for gestational age neonates (30.1 ± 1.2 wks, 985 ± 167 g) were examined during the first five days. By Doppler sonographic measurements the cardiac left ventricular systolic time intervals, peak systolic velocities, end diastolic velocities and pulsatility indices of anterior cerebral artery (ACA), superior mesenteric artery (SMA) and renal artery (RA) were investigated. Results: Significantly increased left ventricular pre ejection period was observed in SGA neonates. Systolic peak velocities and end diastolic velocities of ACA, SMA and RA were significantly decreased in SGA neonates in relationship to AGA neonates. The pulsatility indices were significantly increased in SGA neonates during the first five days. Conclusions: Disturbed left ventricular time intervals were observed as a sign of myocardial dysfunction in SGA neonates. In relationship to the diminished myocardial contractility there were demonstrated pathologically diminished blood flow parameters of peripheral vessels and an increased pulsatility caused by a vasoconstriction in the regional vascular bed. For that reason it seems possible, that the disturbed intrauterine perfusion persists into the postnatal life and could cause later cardiac and metabolic problems.