Aortic and carotid intima-media thickness in term small-for-gestational-age newborns and relationship with prenatal signs of severity

Abstract

Objective To assess carotid and aortic intima–media thickness (IMT) in term small‐for‐gestational‐age (SGA) newborns with and without prenatal signs of severity.

Methods This prospective study comprised 67 cases diagnosed prenatally and 134 normally grown newborns. Cases were subclassified into SGA with no signs of severity and those with signs of severity, defined as a birth weight below the 3rd percentile or abnormal uterine artery Doppler or cerebroplacental ratio. Blood pressure and vascular IMT were evaluated.

Results SGA newborns showed a non‐significant trend for higher values of blood pressure. IMT values were significantly increased in SGA newborns, with and without signs of severity, compared with controls. The magnitude of the increase was higher in SGA newborns with signs of severity.

Conclusions Vascular IMT was increased in SGA newborns, irrespective of the presence or absence of prenatal signs of severity. This finding challenges the notion of ‘constitutionally small’ SGA, and supports the premise that the majority of SGA newborns have true growth restriction and suffer fetal cardiovascular programming.

This study was supported by grants from Instituto de Salud Carlos III and Ministerio de Economia y Competitividad (ref. PI11/00051, PI11/01709, PI12/00801 and SAF2012‐37196) cofinanciado por el Fondo Europeo de Desarrollo Regional de la Unión Europea ‘Una manera de hacer Europa’, Spain; Centro para el Desarrollo Técnico Industrial (Ref. cvREMOD 2009‐2012) apoyado por el Ministerio de Economia y Competitividad y Fondo de inversión local para el empleo, Spain; Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK) and Thrasher Research Fund (Salt Lake City, USA).