Developmental Differences in Left Ventricular Strain in IUGR vs. Control Children the First Three Months of Life

Olov Änghagen, Jan Engvall, Tomas Gottvall, Nina Nelson, Eva Nylander, Peter Bang, Olov Änghagen, Jan Engvall, Tomas Gottvall, Nina Nelson, Eva Nylander, Peter Bang

Abstract

Background: Intrauterine growth restriction (IUGR) may directly affect cardiovascular function in early life. Longitudinal data on left ventricular longitudinal strain (LVLS), a key measure of cardiac function independent of body size, is not available. We hypothesize impaired cardiac function among IUGR newborns and persistence of the impairment until age 3 months.

Method: This is a prospective cohort study of consecutive pregnancies where IUGR was identified at 18-38 weeks gestational age (GA) with healthy controls randomly selected at 18-20 weeks GA. Echocardiograms were performed at birth and at age 3-4 months, and then compared.

Results: At birth, mean (SD) LVLS did not differ between the IUGR group [N = 19; - 15.76 (3.12) %] and controls [N = 35; - 15.53 (3.56) %]. The IUGR group demonstrated no significant change in LVLS at age 3-4 months [- 17.80 (3.82) %], while the control group [- 20.91 (3.31) %] showed a significant increase (P < 0.001). Thus, LVLS was lower in the IUGR group at age 3-4 months (P = 0.003).

Conclusion: The lack of increase in LVLS may suggest that IUGR has a direct impact on cardiac function as early as during the first months of life. Trial registration Clinical trials.gov Identifier: NCT02583763, registration October 22, 2015. Retrospectively registered September 2014-October 2015, thereafter, registered prospectively.

Keywords: Cardiac function; Cardiac strain; Fetal growth retardation (FGR); Infant; Intra-uterine growth restriction (IUGR).

Conflict of interest statement

Authors declare that they have no conflict of interest.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flow diagram of progress throughout the study
Fig. 2
Fig. 2
a Change in left ventricular longitudinal strain (LVLS) in relation to gestationally corrected age (GCA), IUGR. b Change in left ventricular longitudinal strain (LVLS) in relation to gestationally corrected age (GCA), Controls

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