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(Circulation. 2005;111:2623-2628.)
© 2005 American Heart Association, Inc.

Pediatric Cardiology

Impaired Vascular Growth in Late Adolescence After Intrauterine Growth Restriction

J. Brodszki, MD, PhD; T. Länne, MD, PhD; K. Marál, MD, PhD; D. Ley, MD, PhD

From the Departments of Obstetrics and Gynecology (J.B., K.M.) and Pediatrics (D.L.), University Hospital of Lund, Lund University, Lund; and Department of Medicine and Care, Linköping University, Linköping (T.L.), Sweden.

Correspondence to Jana Brodszki, MD, Department of Obstetrics and Gynecology, University Hospital of Lund, SE-221 85 Lund, Sweden. E-mail jana.brodszki{at}gyn.lu.se

Received July 5, 2004; revision received December 16, 2004; accepted February 15, 2005.

Background— Abnormal blood flow in a fetus small for gestational age indicates true fetal intrauterine growth restriction (IUGR). We tested the hypothesis that IUGR with abnormal fetal blood flow is associated with long-term abnormal vascular morphology and function in adolescence.

Methods and Results— In a prospective study, vascular mechanical properties of the common carotid artery (CCA), abdominal aorta, and popliteal artery (PA) were assessed by echo-tracking sonography in 21 adolescents with IUGR and abnormal fetal aortic blood flow and in 23 adolescents with normal fetal growth and normal fetal aortic blood flow. Endothelium-dependent and -independent vasodilatation of the brachial artery was measured by high-resolution ultrasound. After adjustment for body surface area and sex, the IUGR group had significantly smaller end-diastolic vessel diameters than the referents in the abdominal aorta and PA (mean difference, 1.7 mm [95% CI, 0.62 to 2.74] and 0.6 mm [95% CI, 0.25 to 1.02], respectively) (P=0.003 and P=0.002, respectively), with a similar trend in the CCA (P=0.09). A higher resting heart rate was observed in the IUGR group (P=0.01). No differences were found in stiffness or in endothelium-dependent and -independent vasodilatation between the 2 groups.

Conclusions— IUGR caused by placental insufficiency appears to be associated with impaired vascular growth persisting into young adulthood in both men and women. The smaller aortic dimensions and the higher resting heart rate seen in adolescents with previous IUGR may be of importance for future cardiovascular health.

Key Words: endothelium • pediatrics • fetal growth retardation • vessels • ultrasonics

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