Intrauterine growth restriction is associated with persistent aortic wall thickening and glomerular proteinuria during infancy

Abstract

Low birth weight, caused either by preterm birth or by intrauterine growth restriction, has recently been associated with increased rates of adult renal and cardiovascular disease. Since aortic intima-media thickening is a noninvasive marker of preclinical vascular disease, we compared abdominal aortic intima-media thickness among intrauterine growth restricted and equivalent gestational age fetuses in utero and at 18 months of age. The relationship between intrauterine growth restriction, fetal aortic thickening, and glomerular function during infancy was measured by enrolling 44 mothers with single-fetus pregnancies at 32 weeks gestation: 23 growth restricted and 21 of appropriate gestational age as controls. Abdominal aortic intima-media thickness was measured by ultrasound at enrollment and again at 18 months of age. Fetuses with intrauterine growth restriction had significantly higher abdominal aortic intima-media thickness compared with age controls when measured both in utero and at 18 months. At 18 months, the median urinary microalbumin and median albumin-creatinine ratio were significantly higher in those infants who experienced intrauterine growth restriction compared to the controls. Our results show that intrauterine growth restriction is associated with persistent aortic wall thickening and significantly higher microalbuminuria during infancy.

Figure 1

Urine microalbumin in intrauterine growth restricted (IUGR) and appropriate for gestational age (AGA) infants. Median (interquartile range). Urinary microalbumin was significantly higher in the IUGR infants compared with the AGA group (11.1 vs 4.4 mg/l; P<0.001).