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Minerva Obstetrics and Gynecology 2021 May 05

DOI: 10.23736/S2724-606X.21.04823-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Postnatal persistence of cardiac remodelling and dysfunction in late fetal growth restriction

Fatima CRISPI 1, Francesca CROVETTO 1 , Mérida RODRIGUEZ-LÓPEZ 1, 2, Álvaro SEPÚLVEDA-MARTINEZ 1, 3, Jezid MIRANDA 1, 4, Eduard GRATACÓS 1

1 BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), ICGON, IDIBAPS, Centre for Biomedical Research on Rare Diseases (CIBER-ER), University of Barcelona, Barcelona, Spain; 2 Pontificia Universidad Javeriana seccional Cali, Cali, Colombia; 3 Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Clínico de la Universidad de Chile, Santiago de Chile, Chile; 4 Grupo de Investigación en Cuidado Intensivo (GRICIO), Department of Obstetrics and Gynecology, Universidad de Cartagena, Cartagena, Colombia


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Fetal growth restriction is one of the most common obstetric complications, affecting 7-10% of all pregnancies. Affected fetuses are exposed to an adverse environment in utero during a critical time of development and may face long-term health consequences such as increased cardiovascular risk in adulthood. Growth restricted fetuses develop remodelled hearts with signs of systolic and diastolic dysfunction. Cardiac adaptations are more evident in early severe cases, but also present in late onset fetal growth restriction. Cardiovascular remodelling persists into postnatal life, from the neonatal period to adolescence, encompassing an increased susceptibility to adult disease. In this review, we summarize the current evidence on cardiovascular programming associated to fetal growth restriction, its postnatal consequences and potential strategies to reduce their cardiovascular risk.


KEY WORDS: Intrauterine growth restriction; Small-for-gestational age; Fetal programming; Prenatal; Cardiovascular disease; Cardiovascular dysfunction; Echocardiography; Early origins of adult disease

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