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The effect of Intra Uterine Growth Restriction (IUGR) on heart rate and blood pressure in children

By Supratik Chakraborty


Infants with Intra Uterine Growth Restriction (IUGR) are reported to be more prone to develop obesity and cardiovascular problems as adults. Research in this field is complicated due to use of different statistical models and inadequate cardiovascular measurements. \ud I intended to find out whether the difference in body size between IUGR and normal infants persisted through the childhood and whether there were any differences in cardiovascular parameters and maturation of circadian biorhythms between these groups. \ud 75 nine year olds were recruited and forty-one of them were IUGR. All the children had their twenty-four hour heart rate variability, blood pressure and urinary Cortisol excretion measured. \ud IUGR children showed a greater increase in their weight between birth and nine years but the z scores for current weight, height and Body Mass Index (BMI) and incidence of obesity were higher in the control group. \ud Both groups showed similar diurnal variation of all cardiovascular parameters and no evidence of the cardiovascular system being dominated by the Sympathetic nervous system in the IUGR children, which could have been detrimental to their cardiovascular health. \ud The Systolic Blood Pressure (SBP) was significantly higher in the control group. Later weight was the better predictor of SBP. BMI was a significant predictor of SBP. Urinary cortisol/Creatinine ratio was not different between the two groups. \ud I conclude that IUGR children grow faster but remain shorter and lighter than their normal counterparts. IUGR children on average are physiologically indistinguishable from normal children and do not show any abnormality in the cardiovascular parameters, which could link them to future disease. Normal children have higher SBP than the IUGR children which is related to larger body mass. The current body size appears to have more impact on the level of blood pressure at the age of nine years compared to IUGR

Publisher: University of Leicester
Year: 2011
OAI identifier: oai:lra.le.ac.uk:2381/9163

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  1. (2002). Abnormal Doppler flow velocimetry in the growth restricted foetus as a predictor for necrotising enterocolitis.
  2. (1987). Aging of modulation of heart rate.
  3. (2002). Ambulatory blood pressure in 12-year-old children born small for gestational age.
  4. (1993). Ambulatory blood pressure monitoring.
  5. (2007). Archive of Diseases in Childhood. Foetal and Neonatal Edition.2007; 92: F479-F483 Intrauterine growth restriction, compensatory growth and blood pressure: Annual Scientific meeting of British association of Community Child Health,
  6. (2006). Are infant size and growth related to burden of disease in adulthood? A systematic review of literature.
  7. (2003). Associations between prenatal and postnatal growth and adult body size and composition.
  8. (2007). Autonomic nervous system activity in premature and full-term infants from theoretical term to 7 years.
  9. (2002). Birth size, growth, and blood pressure between the ages of 7 and 26 years: failure to support the fetal origins hypothesis.
  10. (2001). Birth weight influences blood pressure values and variability in children and adolescents.
  11. (1996). Breathing, sleep state, and rectal temperature oscillations.
  12. (2003). Catch-up growth in children.
  13. (2005). Catch-up growth or regression to the mean? Recovery from stunting revisited.
  14. (2000). Chaos theory, heart rate variability, and arrhythmic mortality.
  15. (2007). Childhood body-mass index and the risk of coronary heart disease in adulthood. The New England journal of medicine,
  16. (1997). Childhood size is more strongly related than size at birth to glucose and insulin levels in 10-11-year-old children.
  17. (2003). Circadian profile of cardiac autonomic nervous modulation in healthy subjects: differing effects of aging and gender on heart rate variability.
  18. (1997). Circadian rhythm of heart rate variability is reversibly abolished in ischemic stroke. Stroke; a journal of cerebral circulation,
  19. (1989). Circadian variation and triggers of onset of acute cardiovascular disease.
  20. (1994). Clinical uses of ambulatory blood pressure monitoring. Pediatric nephrology
  21. (2000). Cognitive development of term small for gestational age children at five years of age.
  22. (1992). Comparison of the causes and consequences of prematurity and intrauterine growth retardation: a longitudinal study in southern Brazil.
  23. (2005). Could cortisol explain the association between birth weight and cardiovascular disease in later life? A meta-analysis.
  24. (2004). Current concepts in intrauterine growth restriction.
  25. (1998). Current concepts of fetal growth restriction: part I. Causes, classification, and pathophysiology.
  26. (1991). Development of night time temperature rhythms over the first six months of life.
  27. (2000). Development of the placental villous tree and its consequences for fetal growth. European journal of obstetrics, gynecology, and reproductive biology,
  28. (1995). Development of the sleep and autonomic nervous system control in premature and full-term newborn infants.
  29. (1996). Diurnal heart rate variability in healthy subjects: effects of aging and sex difference.
  30. (1999). Early growth and cardiovascular disease.
  31. (2001). Early growth and coronary heart disease in later life: longitudinal
  32. (1995). Early origin of coronary heart disease (the 'Barker hypothesis'). Hypotheses, no matter how intriguing, need rigorous attempts at refutation.
  33. (2004). Effect of birth weight on blood pressure and body size in early adolescence.
  34. (2003). Effects of early childhood supplementation on the educational achievement of women.
  35. (1997). Effects of intrauterine growth retardation in premature infants on early childhood growth.
  36. (2001). Effects of prenatal exposure to the Dutch famine on adult disease in later life: an overview. Molecular and cellular endocrinology,
  37. (1994). Endogenous and stimulated GH secretion, urinary GH excretion, and plasma IGF-I and IGF-II levels in prepubertal children with short stature after intrauterine growth retardation. The Dutch Working Group on Growth Hormone.
  38. (2003). European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement.
  39. (2001). Familial thrombophilia and the occurrence of fetal growth restriction.
  40. (2007). Fetal growth restriction: relation to growth and obesity at the age of 9 years. Archives of disease in childhood.Fetal and neonatal edition,
  41. (1980). Fetal growth retardation in cigarette-smoking mothers is not due to decreased maternal food intake.
  42. (1999). Fetal origins of adult disease - The hypothesis revisited.
  43. (1995). Fetal origins of coronary heart disease.
  44. (1998). Growth and development of term children born with low birth weight: effects of genetic and environmental factors.
  45. (1988). Growth and development of term disproportionate smallfor-gestational age infants at the age of 7 years.
  46. (1998). Growth of infants and young children born small or large for gestational age: findings from the Third National Health and Nutrition Examination Survey.
  47. (2001). Growth-restricted premature infants are at increased risk for low thyroxine. Early human development,
  48. (1995). Growth, development and behaviour in adolescents born small-for-gestational-age.
  49. (2001). Heart rate variability in healthy children and adolescents is partially related to age and gender.
  50. (2003). Heart rate variability in healthy children.
  51. (1995). Heart rate variability in infants, children and young adults.
  52. (2002). Heart rate variability in normotensive healthy children with aging. Clinical and experimental hypertension,
  53. (1994). Heart rate variability: a measure of cardiac autonomic tone.
  54. (2004). Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system. Swiss medical weekly :
  55. (1996). Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the
  56. (1993). Heart rate variability.
  57. (1996). Heart rate variations during sleep in preadolescents.
  58. Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction.
  59. (1984). Heterogeneous growth and mental development of intrauterine growthretarded infants during the first 3 years of life.
  60. (1996). High-dose growth hormone treatment of short children born small for gestational age.
  61. (1986). Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales.
  62. Insulin resistance syndrome in 8-year-old Indian children: small at birth, big at 8 years, or both?
  63. (2003). International Small for Gestational Age Advisory Board consensus development conference statement: management of short children born small for gestational age,
  64. (2000). Interobserver reproducibility of heart rate variability in children (the Bogalusa Heart Study).
  65. (1996). Intrauterine growth and gestational age in preterm infants with cerebral palsy.
  66. (1990). Intrauterine growth and spastic cerebral palsy. I. Association with birth weight for gestational age.
  67. (1992). Intrauterine growth in children with cerebral palsy. Acta Paediatrica
  68. (1998). Intrauterine growth restriction: identification and management.
  69. (2002). Intrauterine growth restriction.
  70. (1996). Intrauterine growth retardation and postnatal growth failure associated with deletion of the insulin-like growth factor I gene. The New England journal of medicine,
  71. (1992). Intrauterine growth retardation: definition, classification, and etiology. Clinical obstetrics and gynecology,
  72. (1998). Intrauterine growth retardation.
  73. (1984). Introduction: Intrauterine growth retardation--identification of research needs and goals.
  74. (2000). Invited commentary: Association between restricted fetal growth and adult chronic disease: Is it causal? Is it important?
  75. (2003). Learning, cognitive, and attentional problems in adolescents born small for gestational age.
  76. (2005). Leicester Study Title: Study on Heart rate and Blood Pressure changes in seven-year old healthy children including some who were born with a low birth weight Version 2
  77. (2002). Leptin in relation to growth and developmental processes in the fetus. Seminars in reproductive medicine,
  78. (1998). Levels and patterns of intrauterine growth retardation in developing countries.
  79. (1989). Long-term growth in small-fordate children.
  80. (1995). Maternal anthropometry and pregnancy outcomes. A WHO collaborative study.
  81. (2002). Migration within Great Britain and cardiovascular disease: early life and adult environmental factors.
  82. (2000). Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. The Vermont Oxford Network.
  83. (1996). Morbidity during the first year of life in small for gestational age infants.
  84. (1994). Mothers, Babies and disease in later life. First edn.
  85. (1998). Neurodevelopmental outcome at three years of age after fetal 'brain-sparing'. Early human development,
  86. (2005). Nocturnal excretion of 6-sulphatoxymelatonin in children and adolescents with autistic disorder.
  87. (2000). Nursing management: hypertension. In:
  88. (1996). Obstetrics: Normal & Problem Pregnancies. 3rd edn.
  89. (1997). Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects.
  90. (2000). Overweight and obesity in preschool children from developing countries. International journal of obesity and related metabolic METGES, C.C.,
  91. (1994). Power spectrum analysis of heart rate variability: a tool to explore neural regulatory mechanisms.
  92. (1997). Prediction of the outcome of growth at 2 years of age in neonates with intra-uterine growth retardation. Early human development,
  93. (1999). Prevalence and trends in overweight among US children and adolescents,
  94. (2001). Prevalence and trends in overweight and obesity in three cross sectional studies of British Children,
  95. (2005). Reduced cardiac parasympathetic activity in children with autism.
  96. (2001). Relations between the development of patterns of sleeping heart rate and body temperature in infants. Archives of disease in childhood.Fetal and neonatal edition,
  97. (2003). Relationship between birth weight and blood pressure variability in children.
  98. (1996). Respiratory characteristics during sleep in healthy small-for-gestational age newborns.
  99. (1996). Review of the evidence on fetal and early childhood antecedents of adult chronic disease.
  100. (1993). Role of insulin-like growth factors in embryonic and postnatal growth.
  101. (1998). Smoking, intra-uterine growth retardation and sudden infant death syndrome.
  102. (2006). Sudden Infant Death Syndrome and the time of death: factors associated with night-time and day-time deaths.
  103. (1997). Sympathovagal balance: a critical appraisal.
  104. (1999). Technical aspects of blood pressure measurement in pediatric patients.
  105. (2001). Term infants with fetal growth restriction are not at increased risk for low intelligence scores at age 17 years.
  106. (1991). The concentration of insulin-like growth factor-I and insulin-like growth factor-binding protein-1 in human umbilical cord serum at delivery: relation to fetal weight.
  107. (2003). The developmental origins of adult disease.
  108. (2003). The insulin-like growth factors and feto-placental growth.
  109. (2002). The relative contributions of birth weight, weight change, and current weight to insulin resistance in contemporary 5-year-olds: the EarlyBird Study.
  110. (2003). The risks of adverse neonatal outcome among preterm small for gestational age infants according to neonatal versus fetal growth standards.
  111. (1985). The search for perinatal definitions and standards.
  112. (1987). Ultrasonic recognition of the small-for-gestational-age fetus.
  113. (2002). Unravelling the fetal origins
  114. (2002). Working Group on Blood Pressure Monitoring of the European Society of HypertensionInternational Protocol for validation of bloodpressure measuring devices in adults.

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