Differences in cardiac geometry in relation to body size among neonates with abnormal prenatal growth and body size at birth

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Olander , R F W , Sundholm , J K M , Ojala , T H , Andersson , S & Sarkola , T 2020 , ' Differences in cardiac geometry in relation to body size among neonates with abnormal prenatal growth and body size at birth ' , Ultrasound in Obstetrics & Gynecology , vol. 56 , no. 6 , pp. 864-871 . https://doi.org/10.1002/uog.21972

Title: Differences in cardiac geometry in relation to body size among neonates with abnormal prenatal growth and body size at birth
Author: Olander, R. F. W.; Sundholm, J. K. M.; Ojala, T. H.; Andersson, S.; Sarkola, T.
Contributor organization: Children's Hospital
HUS Children and Adolescents
Date: 2020-12
Language: eng
Number of pages: 8
Belongs to series: Ultrasound in Obstetrics & Gynecology
ISSN: 0960-7692
DOI: https://doi.org/10.1002/uog.21972
URI: http://hdl.handle.net/10138/338123
Abstract: Objectives Both excessive and restricted fetal growth are associated with changes in cardiac geometry and function at birth. There are significant issues when indexing cardiac parameters for body size in the neonatal period. The aims of this study were to determine to what extent cardiac geometry is dependent on body size in term and preterm neonates with restricted or excessive fetal growth and how this is affected by adiposity. Methods This was a cross-sectional study of neonates born between 31 and 42 weeks of gestation, divided into three groups: (1) small-for-gestational age (SGA, birth weight > 2 SD below the mean); (2) large-for-gestational age (LGA, birth weight > 2 SD above the mean); and (3) appropriate-for-gestational-age controls (AGA, birth weight Results In total, 174 neonates were included, of which 39 were SGA, 45 were LGA and 90 were AGA. Body size was reflected in cardiac dimensions, with differences in cardiac dimensions disappearing between the SGA and AGA groups when indexed for body surface area (BSA) or thoracic circumference. The same was true for the differences in atrial and ventricular areas between the LGA and AGA groups. However, left ventricular inflow and outflow tract dimensions did not follow this trend as, when indexed for BSA, they were associated negatively with adiposity, resulting in diminished dimensions in LGA compared with AGA and SGA neonates. Adiposity was associated positively with left ventricular mass, right ventricular length and area and right atrial area. The SGA group showed increased right ventricular fractional area change, possibly reflecting differences in the systolic function of the right ventricle. We found evidence of altered diastolic function between the groups, with the mitral valve inflow E-to lateral E'-wave peak velocity ratio being increased in the LGA group and decreased in the SGA group. Conclusions Cardiac geometry is explained by body size in both term and preterm AGA and SGA infants. However, the nature of the relationship between body size and cardiac dimensions may be influenced by adiposity in LGA infants, leading to underestimation of left ventricular inflow and outflow tract dimensions when adjusted for BSA. Adjustments for thoracic circumference provide similar results to those for BSA. Copyright (C) 2020 ISUOG. Published by John Wiley & Sons Ltd.
Subject: abnormal intrauterine growth
large-for-gestational age
small-for-gestational age
3123 Gynaecology and paediatrics
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: acceptedVersion

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