Arterial health during early childhood following abnormal fetal growth

Rasmus F.W Olander,Johnny K.M Sundholm,Taisto Sarkola,Sanna Suonsyrjä

doi:10.1186/s12887-021-02951-2

Rasmus F.W Olander, Johnny K.M Sundholm + Show 2 more

Open Access

https://doi.org/10.1186/s12887-021-02951-2

Copy DOI

Abstract

BackgroundAbnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood.MethodsWe examined 90 children (median age 5.81 years, interquartile range: 5.67; 5.95), born small for gestational age with fetal growth restriction, large or appropriate for gestational age (SGA, N = 23, LGA, N = 19, AGA N = 48). We measured body composition, anthropometrics, blood pressure, pulse wave velocity (PWV), lipids, glucose and inflammatory markers, and assessed carotid, brachial, radial and femoral arterial morphology and stiffness using very-high resolution ultrasound (46–71 MHz).ResultsLGA showed increased anthropometry, lean body mass and body mass index. SGA displayed decreased anthropometry and lean body mass. Blood pressure, PWV, carotid artery stiffness and blood work did not differ groupwise. Differences in lumen diameters, intima-media thicknesses (IMT) and adventitia thicknesses disappeared when adjusted for lean body mass and sex. In multiple regression models arterial dimensions were mainly predicted by lean body mass, with birth weight remaining associated only with carotid and brachial lumen dimensions, and not with IMTs. Carotid-femoral PWV was predicted by height and blood pressure only. No independent effect of adiposity was observed.ConclusionsArterial dimensions in childhood associate with current anthropometrics, especially lean body mass, and sex, explaining differences in arterial layer thickness. We found no signs of fetal programming of cardiovascular risk or arterial health in early childhood.

Highlights

Abnormal fetal growth is associated with increased cardiovascular risk in adulthood
When examining follow-up participants and non-participants, we found no differences for group composition, sex, gestational parameters or birth weight, height, or head circumference Z-score
In the large for gestational age (LGA) group, one child had been diagnosed with epilepsy without the need of regular medication, and one with corpus callosum agenesia, while of the appropriate for gestational age (AGA) children one had been diagnosed with unspecified motor delay and one with mild asymmetric cerebral palsy

Summary

Introduction

Abnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood. Conventional ultrasound has previously been shown to be inadequate for measuring these dimensions in infants and young children and instead very-high resolution ultrasound has been validated (VHRU; peak frequencies 46–71 MHz) as an accurate non-invasive method to assess minute superficial arterial layer thickness in this age group [10, 11]. It is still unclear whether the reported increased carotid IMT in children with altered fetal growth reflects an increase in cardiovascular risk profile, due to the use of conventional ultrasound in previous studies. We are the first to report on arterial dimensions during early childhood in the setting of abnormal fetal growth using methods validated for this age group

Objectives

Methods

Results

Discussion

Conclusion