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Antenatal hemodynamic findings and heart rate variability in early school-age children born with fetal growth restriction.
Korkalainen, Noora; Mäkikallio, Timo; Räsänen, Juha; Huikuri, Heikki; Mäkikallio, Kaarin.
Afiliação
  • Korkalainen N; Department of Obstetrics and Gynecology, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Mäkikallio T; PEDEGO Research Group, University of Oulu, Oulu, Finland.
  • Räsänen J; Department of Cardiology, Oulu University Hospital, Oulu, Finland.
  • Huikuri H; Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
  • Mäkikallio K; Department of Cardiology, Oulu University Hospital, Oulu, Finland.
J Matern Fetal Neonatal Med ; 34(14): 2267-2273, 2021 Jul.
Article em En | MEDLINE | ID: mdl-31510812
BACKGROUND: According to epidemiological studies, impaired intrauterine growth increases the risk for cardiovascular morbidity and mortality in adulthood. Heart rate variability (HRV), which reflects the autonomic nervous system function, has been used for risk assessment in adults while its dysfunction has been linked to poor cardiovascular outcome. OBJECTIVE: We hypothesized that children who were born with fetal growth restriction (FGR) and antenatal blood flow redistribution have decreased HRV at early school age compared to their gestational age matched peers with normal intrauterine growth. STUDY DESIGN: A prospectively collected cohort of children born with FGR (birth weight <10th percentile and/or abnormal umbilical artery flow, n = 28) underwent a 24-hour Holter monitoring at the mean age of 9 years and gestational age matched children with birth weight appropriate for gestational age (AGA, n = 19) served as controls. Time- and frequency domain HRV indices were measured and their associations with antenatal hemodynamic changes were analyzed. RESULTS: Time- and frequency domain HRV parameters (standard deviation of R-R intervals, SDNN; low frequency, LF; high frequency, HF; LF/HF; very low frequency, VLF) did not differ significantly between FGR and AGA groups born between 24 and 40 weeks. Neither did they differ between children born with FGR and normal umbilical artery pulsatility or increased umbilical artery pulsatility. In total, 56% of the FGR children demonstrated blood flow redistribution (cerebroplacental ratio, CPR < -2 SD) during fetal life and their SDNN (p = .01), HF (p = .03) and VLF (p = .03) values were significantly lower than in FGR children with CPR ≥ -2SD. CONCLUSIONS: Early school age children born with FGR and intrauterine blood flow redistribution demonstrated altered heart rate variability. These prenatal and postnatal findings may be helpful in targeting preventive cardiovascular measures in FGR.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ultrassonografia Pré-Natal / Retardo do Crescimento Fetal Tipo de estudo: Diagnostic_studies / Risk_factors_studies Limite: Adult / Child / Female / Humans / Pregnancy Idioma: En Revista: J Matern Fetal Neonatal Med Assunto da revista: OBSTETRICIA / PERINATOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Finlândia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ultrassonografia Pré-Natal / Retardo do Crescimento Fetal Tipo de estudo: Diagnostic_studies / Risk_factors_studies Limite: Adult / Child / Female / Humans / Pregnancy Idioma: En Revista: J Matern Fetal Neonatal Med Assunto da revista: OBSTETRICIA / PERINATOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Finlândia