Intrauterine growth restriction - impact on cardiovascular diseases later in life

Abstract

Intrauterine growth restriction (IUGR) is a fetal pathology which leads to increased risk for certain neonatal complications. Furthermore, clinical and experimental studies revealed that IUGR is associated with a significantly higher incidence of metabolic, renal and cardiovascular diseases (CVD) later in life. One hypothesis for the higher risk of CVD after IUGR postulates that IUGR induces metabolic alterations that then lead to CVD.This minireview focuses on recent studies which demonstrate that IUGR is followed by early primary cardiovascular alterations which may directly progress to CVD later in life.

Prematurity With Extrauterine Growth Restriction Increases the Risk of Higher Levels of Glucose, Low-Grade of Inflammation and Hypertension in Prepubertal Children

“…It has also been hypothesised that a distinct antiangiogenic status with impaired microcirculation (38) or alterations in the organogenesis of kidneys in response to inflammation, oxidative stress, and nephrotoxicity injuries (39, 40) could be involved. On the other hand, IUGR has also been associated with a higher risk of increased BP values (41) and cardiovascular complications (42). Haemodynamic redistribution and cardiovascular remodelling with an increase arterial thickness in response to adaptation to insufficient nutrition (43) may predict both cardiac dysfunction and hypertension in childhood (44).…”

“…Similarly as the EUGR group, PREM children were selected at prepubertal age. The third group included 123 healthy children born at term with adequate weight and height for GA (38)(39)(40)(41)(42) weeks' GA and 2,500-3,500 g at birth), with no relevant antecedents of disease, and free of disease after checking for normal both physical and biochemical evaluation (control group). This group comprised prepubertal children, who were attended to in the hospital for minor disease and required blood analysis, but with normal results in clinical and analytical tests.…”

Intrauterine Wachstumsrestriktion: Transsektorale, interdisziplinäre und multiprofessionelle Betreuung von Schwangeren und Neugeborenen im Feto-Neonat-Pfad: Ein Projekt des Innovationsfonds

“…Entscheidend für die gesundheitsökonomische Beurteilung von fetaler Wachstumsrestriktion sind die Langzeiteffekte: Eine IUGR führt zu einem früheren arteriellen Remodelling, was einen Risikofaktor für spätere kardiovaskuläre Erkrankungen darstellt [27]. Die Lungenfunktion ist im Schulalter bei Kindern reduziert, die von IUGR betroffen waren [28].…”

Modulation of the Epigenome by Nutrition and Xenobiotics during Early Life and across the Life Span: The Key Role of Lifestyle

“…Furthermore, alcohol consumption during pregnancy can perturb normal neuronal development and promote proinflammatory cytokine release in offspring [5,6]. Similarly, a maternal high-fat diet can contribute to proinflammatory cytokine production, and maternal obesity can promote changes in methylation patterns [4]. Finally, exposure to pesticides and metals during pregnancy and/or early life can promote inflammation, neurodevelopmental disorders, and progressive neurodegeneration later in life [7,8].…”

“…as well as sufficient levels of B12 and B6 vitamins [2,3]. Deficiencies in these micronutrients during early life have been associated with increased risk of cardiovascular, metabolic, and neurological diseases later in life [4,5]. In addition to nutrients, other lifestyle factors such as smoking, alcohol, stress, and food pesticides have also been reported to increase the risk of disease development in adulthood according to genetic variations [5].…”