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Am J Perinatol 2012; 29(06): 441-448
DOI: 10.1055/s-0032-1304825
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association of Abdominal Aortic Wall Thickness in the Newborn with Maternal Factors

Satoru Iwashima
1   Department of Pediatrics, Hamamatsu University School of Medicine, Japan
,
Takamichi Ishikawa
1   Department of Pediatrics, Hamamatsu University School of Medicine, Japan
,
Ohishi Akira
1   Department of Pediatrics, Hamamatsu University School of Medicine, Japan
,
Hiroaki Itou
2   Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Japan
› Author Affiliations
Further Information

Publication History

22 August 2011

09 November 2011

Publication Date:
07 March 2012 (online)

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Abstract

Purpose The goal of the present study is to carry out prospective echocardiographic measurements of intima-media thickness (IMT) in the abdominal artery of newborns.

Methods Study subjects were 96 mothers and their newborns. We measured the adjusted IMT (aIMT, mm/mm) of newborn abdominal arteries by high-resolution ultrasound and evaluated the association of aIMT with various maternal and newborn factors.

Results Negative correlations were observed between aIMT and gestational age (r = − 0.678, p < 0.01) and positive correlations between aIMT and placenta-to-fetus weight ratio (r = 0.418, p < 0.01). Comparing the small-for-gestational-age (SGA) versus appropriate-for-gestational-age (AGA) categories, aIMT in the SGA (n = 14) was greater than in the AGA (n = 82), with values of [0.115 (0.117) mm/mm versus 0.084 (0.074) mm/mm, p < 0.01], respectively. A multiple linear regression analysis was performed with aIMT as a dependent variable, and significant correlations were noted with gestational age (R 2 = 0.524, β = − 0.515, p < 0.001 for gestational age).

Conclusion On the basis of these findings, we suggest that aIMT thickness is associated with placenta-to-fetus weight ratio and gestational age, and that increased values of aIMT in SGA may indicate presence of a latent link to cardiovascular disease that might otherwise go undetected in infancy.

Keywords

cardiovascular risk - intima-media thickness - newborn - maternal factors
 

  • References

  • 1 Barker DJP, Osmond C. Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales. Lancet 1986; 1: 1077-1081
    PubMedGoogle Scholar
  • 2 Barker DJ, Winter PD, Osmond C, Margetts B, Simmonds SJ. Weight in infancy and death from ischaemic heart disease. Lancet 1989; 2: 577-580
    PubMedGoogle Scholar
  • 3 Hales CN, Barker DJ. Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia 1992; 35: 595-601
    CrossrefPubMedGoogle Scholar
  • 4 Barker DJP, Gluckman PD, Godfrey KM, Harding JE, Owens JA, Robinson JS. Fetal nutrition and cardiovascular disease in adult life. Lancet 1993; 341: 938-941
    CrossrefPubMedGoogle Scholar
  • 5 Barker DJ, Osmond C, Forsén TJ, Kajantie E, Eriksson JG. Trajectories of growth among children who have coronary events as adults. N Engl J Med 2005; 353: 1802-1809
    CrossrefPubMedGoogle Scholar
  • 6 Phillips DI, Barker DJ, Hales CN, Hirst S, Osmond C. Thinness at birth and insulin resistance in adult life. Diabetologia 1994; 37: 150-154
    CrossrefPubMedGoogle Scholar
  • 7 Skilton MR, Evans N, Griffiths KA, Harmer JA, Celermajer DS. Aortic wall thickness in newborns with intrauterine growth restriction. Lancet 2005; 365: 1484-1486
    CrossrefPubMedGoogle Scholar
  • 8 McGill Jr HC, McMahan CA, Herderick EE , et al. Effects of coronary heart disease risk factors on atherosclerosis of selected regions of the aorta and right coronary artery. PDAY Research Group. Pathobiological Determinants of Atherosclerosis in Youth. Arterioscler Thromb Vasc Biol 2000; 20: 836-845
    CrossrefPubMedGoogle Scholar
  • 9 Järvisalo MJ, Jartti L, Näntö-Salonen K , et al. Increased aortic intima-media thickness: a marker of preclinical atherosclerosis in high-risk children. Circulation 2001; 104: 2943-2947
    CrossrefPubMedGoogle Scholar
  • 10 Godfrey KM. The role of the placenta in fetal programming—a review. Placenta 2002; 23 (Suppl A) S20-S27
    CrossrefPubMedGoogle Scholar
  • 11 Louey S, Cock ML, Harding R. Postnatal development of arterial pressure: influence of the intrauterine environment. Arch Physiol Biochem 2003; 111: 53-60
    PubMedGoogle Scholar
  • 12 Seckl JR, Holmes MC. Mechanisms of disease: glucocorticoids, their placental metabolism and fetal “programming” of adult pathophysiology. Nat Clin Pract Endocrinol Metab 2007; 3: 479-488
    CrossrefPubMedGoogle Scholar
  • 13 Barker DJ, Bull AR, Osmond C, Simmonds SJ. Fetal and placental size and risk of hypertension in adult life. BMJ 1990; 301: 259-262
    CrossrefPubMedGoogle Scholar
  • 14 Nishida H, Sakamoto S, Sakanoue M. New fetal growth curves for Japanese. Acta Paediatr Scand Suppl 1985; 319: 62-67
    PubMedGoogle Scholar
  • 15 Dalla Pozza R, Bechtold S, Bonfig W , et al. Age of onset of type 1 diabetes in children and carotid intima medial thickness. J Clin Endocrinol Metab 2007; 92: 2053-2057
    CrossrefPubMedGoogle Scholar
  • 16 Hirai T, Sasayama S, Kawasaki T, Yagi S. Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis. Circulation 1989; 80: 78-86
    CrossrefPubMedGoogle Scholar
  • 17 Salomaa V, Riley W, Kark JD, Nardo C, Folsom AR. Non-insulin-dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes. The ARIC Study. Atherosclerosis Risk in Communities Study. Circulation 1995; 91: 1432-1443
    CrossrefPubMedGoogle Scholar
  • 18 Siewert-Delle A, Ljungman S. The impact of birth weight and gestational age on blood pressure in adult life: a population-based study of 49-year-old men. Am J Hypertens 1998; 11 (8 Pt 1) 946-953
    CrossrefPubMedGoogle Scholar
  • 19 Bonamy AK, Bendito A, Martin H, Andolf E, Sedin G, Norman M. Preterm birth contributes to increased vascular resistance and higher blood pressure in adolescent girls. Pediatr Res 2005; 58: 845-849
    CrossrefPubMedGoogle Scholar
  • 20 Johansson S, Iliadou A, Bergvall N, Tuvemo T, Norman M, Cnattingius S. Risk of high blood pressure among young men increases with the degree of immaturity at birth. Circulation 2005; 112: 3430-3436
    CrossrefPubMedGoogle Scholar
  • 21 Harding JE. The nutritional basis of the fetal origins of adult disease. Int J Epidemiol 2001; 30: 15-23
    CrossrefPubMedGoogle Scholar
  • 22 Fowden AL, Forhead AJ, Coan PM, Burton GJ. The placenta and intrauterine programming. J Neuroendocrinol 2008; 20: 439-450
    CrossrefPubMedGoogle Scholar
  • 23 Wen X, Triche EW, Hogan JW, Shenassa ED, Buka SL. Association between placental morphology and childhood systolic blood pressure. Hypertension 2011; 57: 48-55
    CrossrefPubMedGoogle Scholar
  • 24 Hemachandra AH, Klebanoff MA, Duggan AK, Hardy JB, Furth SL. The association between intrauterine growth restriction in the full-term infant and high blood pressure at age 7 years: results from the Collaborative Perinatal Project. Int J Epidemiol 2006; 35: 871-877
    CrossrefPubMedGoogle Scholar
  • 25 Barker DJ, Godfrey KM, Osmond C, Bull A. The relation of fetal length, ponderal index and head circumference to blood pressure and the risk of hypertension in adult life. Paediatr Perinat Epidemiol 1992; 6: 35-44
    CrossrefPubMedGoogle Scholar
  • 26 Eriksson J, Forsén T, Tuomilehto J, Osmond C, Barker D. Fetal and childhood growth and hypertension in adult life. Hypertension 2000; 36: 790-794
    CrossrefPubMedGoogle Scholar
  • 27 Forsén T, Nissinen A, Tuomilehto J, Notkola IL, Eriksson J, Vinni S. Growth in childhood and blood pressure in Finnish children. J Hum Hypertens 1998; 12: 397-402
    CrossrefPubMedGoogle Scholar
  • 28 Whincup P, Cook D, Papacosta O, Walker M. Birth weight and blood pressure: cross sectional and longitudinal relations in childhood. BMJ 1995; 311: 773-776
    CrossrefPubMedGoogle Scholar
  • 29 Koklu E, Ozturk MA, Kurtoglu S, Akcakus M, Yikilmaz A, Gunes T. Aortic intima-media thickness, serum IGF-I, IGFBP-3, and leptin levels in intrauterine growth-restricted newborns of healthy mothers. Pediatr Res 2007; 62: 704-709
    CrossrefPubMedGoogle Scholar
  • 30 Cheung YF, Wong KY, Lam BC, Tsoi NS. Relation of arterial stiffness with gestational age and birth weight. Arch Dis Child 2004; 89: 217-221
    CrossrefPubMedGoogle Scholar
  • 31 Rossi P, Tauzin L, Marchand E, Simeoni U, Francès Y. [Arterial blood pressure and arterial stiffness in adolescents are related to gestational age]. Arch Mal Coeur Vaiss 2006; 99: 748-751
    PubMedGoogle Scholar
  • 32 Barker DJ. Adult consequences of fetal growth restriction. Clin Obstet Gynecol 2006; 49: 270-283
    CrossrefPubMedGoogle Scholar
  • 33 Barker DJ. In utero programming of cardiovascular disease. Theriogenology 2000; 53: 555-574
    CrossrefPubMedGoogle Scholar
  • 34 Bateson P, Barker D, Clutton-Brock T , et al. Developmental plasticity and human health. Nature 2004; 430: 419-421
    CrossrefPubMedGoogle Scholar
  • 35 Martyn CN, Greenwald SE. Impaired synthesis of elastin in walls of aorta and large conduit arteries during early development as an initiating event in pathogenesis of systemic hypertension. Lancet 1997; 350: 953-955
    CrossrefPubMedGoogle Scholar
  • 36 Ligi I, Grandvuillemin I, Andres V, Dignat-George F, Simeoni U. Low birth weight infants and the developmental programming of hypertension: a focus on vascular factors. Semin Perinatol 2010; 34: 188-192
    CrossrefPubMedGoogle Scholar
  • 37 Burkhardt T, Matter CM, Lohmann C , et al. Decreased umbilical artery compliance and IGF-I plasma levels in infants with intrauterine growth restriction—implications for fetal programming of hypertension. Placenta 2009; 30: 136-141
    CrossrefPubMedGoogle Scholar
  • 38 Halcox JPJ, Donald AE, Ellins E , et al. Endothelial function predicts progression of carotid intima-media thickness. Circulation 2009; 119: 1005-1012
    CrossrefPubMedGoogle Scholar
  • 39 Barker DJ, Thornburg KL, Osmond C, Kajantie E, Eriksson JG. The surface area of the placenta and hypertension in the offspring in later life. Int J Dev Biol 2010; 54: 525-530
    CrossrefPubMedGoogle Scholar
  • 40 Brawley L, Itoh S, Torrens C , et al. Dietary protein restriction in pregnancy induces hypertension and vascular defects in rat male offspring. Pediatr Res 2003; 54: 83-90
    CrossrefPubMedGoogle Scholar
  • 41 Franco MdoC, Arruda RM, Dantas AP , et al. Intrauterine undernutrition: expression and activity of the endothelial nitric oxide synthase in male and female adult offspring. Cardiovasc Res 2002; 56: 145-153
    CrossrefPubMedGoogle Scholar
  • 42 Gardner DS, Jackson AA, Langley-Evans SC. Maintenance of maternal diet-induced hypertension in the rat is dependent on glucocorticoids. Hypertension 1997; 30: 1525-1530
    CrossrefPubMedGoogle Scholar
  • 43 Holemans K, Gerber R, Meurrens K, De Clerck F, Poston L, Van Assche FA. Maternal food restriction in the second half of pregnancy affects vascular function but not blood pressure of rat female offspring. Br J Nutr 1999; 81: 73-79
    PubMedGoogle Scholar
  • 44 Kwong WY, Wild AE, Roberts P, Willis AC, Fleming TP. Maternal undernutrition during the preimplantation period of rat development causes blastocyst abnormalities and programming of postnatal hypertension. Development 2000; 127: 4195-4202
    PubMedGoogle Scholar
  • 45 McMullen S, Langley-Evans SC. Maternal low-protein diet in rat pregnancy programs blood pressure through sex-specific mechanisms. Am J Physiol Regul Integr Comp Physiol 2005; 288: R85-R90
    PubMedGoogle Scholar
  • 46 Molnar J, Howe DC, Nijland MJ, Nathanielsz PW. Prenatal dexamethasone leads to both endothelial dysfunction and vasodilatory compensation in sheep. J Physiol 2003; 547 (Pt 1) 61-66
    CrossrefPubMedGoogle Scholar
  • 47 Khorram O, Momeni M, Desai M, Ross MG. Nutrient restriction in utero induces remodeling of the vascular extracellular matrix in rat offspring. Reprod Sci 2007; 14: 73-80
    CrossrefPubMedGoogle Scholar
  • 48 Koklu E, Kurtoglu S, Akcakus M, Yikilmaz A, Coskun A, Gunes T. Intima-media thickness of the abdominal aorta of neonate with different gestational ages. J Clin Ultrasound 2007; 35: 491-497
    CrossrefPubMedGoogle Scholar