Differential effect of assisted reproductive technology and small-for-gestational age on fetal cardiac remodeling.

摘要: Objective Fetuses conceived by assisted reproductive technology (ART) and those that are small-for-gestational age (SGA) show cardiovascular remodeling in utero; however, these two conditions often associated. We aimed to evaluate the differential effect of ART SGA on fetal cardiac remodeling. Methods This was a prospective cohort study term singleton pregnancies seen at our department between April 2011 September 2013. The divided according growth mode conception into following four groups: 102 appropriate-for-gestational-age (AGA) fetuses spontaneously (controls), 72 AGA (ART-AGA), 31 (ART-SGA) 28 naturally (Spont-SGA). defined as birth weight < 10th centile. Fetal echocardiography performed 28–32 weeks assess dimensions, geometry function. Results ART had dilated atria (mean left atrium-to-heart area ratio: controls, 15 ± 2.7%; ART-AGA, 18 ± 4.1%; Spont-SGA, 14 ± 3.7%) more globular ventricles (left ventricular sphericity index: 1.77 ± 0.2; 1.68 ± 0.2; 1.72 ± 0.2), with normally sized hearts. In contrast, enlarged hearts (cardiothoracic 24 ± 3%; 24 ± 4%; 29 ± 6%), preserved atrial size, concentric hypertrophic ventricle relative wall thickness: 0.48 ± 0.17; 0.54 ± 0.13; 0.63 ± 0.23). Both decreased longitudinal motion (tricuspid annular ring displacement: 6.5 ± 0.8 mm; 5.5 ± 0.7 5.9 ± 0.6 mm) impaired relaxation isovolumetric time: 47.0 ± 7.3 ms; 50.0 ± 7.9 49.5 ± 9.3 ms). ART-SGA presented combination features from both groups. Conclusion SGA were associated distinct patterns remodeling, supporting concept they independent causes programming. Copyright © 2016 ISUOG. Published John Wiley & Sons Ltd.