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Delivery of small-for-gestational-age neonate and association with early-onset impaired maternal endothelial function

Hillman, SL; Kubba, T; Williams, DJ; (2017) Delivery of small-for-gestational-age neonate and association with early-onset impaired maternal endothelial function. Ultrasound in Obstetrics & Gynecology , 49 (1) pp. 150-154. 10.1002/uog.17342. Green open access

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Abstract

Objective Women who have delivered a small-for-gestational-age (SGA) infant are at an increased risk of developing cardiovascular disease (CVD) in later life. Endothelial dysfunction is a subclinical sign of early CVD. It is unknown whether women who have recently had a pregnancy complicated by SGA, in the absence of other maternal and fetal diseases, have subclinical endothelial dysfunction. Our aim was to assess maternal endothelial function 6 months after a pregnancy complicated by SGA. Methods This was a case–control study conducted in a tertiary referral hospital in London, UK, over a 15-month period. Flow-mediated dilatation (FMD) of the brachial artery was measured in women 6.9 ± 2.5 months after childbirth. Forty-four women were included in the study, of whom 15 had a SGA neonate (mean ± SD customized birth centile of 1.9 ± 2.3) and 29 delivered an appropriately grown baby (mean ± SD customized birth centile of 47.5 ± 26.3). The primary continuous variable, FMD, was assessed in each group and compared using unpaired t-test. Results Women who had a SGA neonate had lower postpartum FMD (6.79 ± 0.95%) than did those who had an appropriately grown offspring (10.26 ± 2.44% (95% CI for difference between groups, −5.37 to −1.57); P = 0.0007). There were no differences in postnatal maternal blood pressure, abdominal circumference, weight and glucose, insulin and lipid profiles between the two groups. Conclusions Women who had a pregnancy affected by SGA, probably due to placental failure in the absence of pre-eclampsia, have evidence of subclinical endothelial dysfunction within 6 months of childbirth. These women may benefit from lifestyle measures focused on the primary prevention of CVD. Further research in larger populations is needed to ascertain if such postpartum maternal endothelial dysfunction is a pregnancy-induced phenomenon or if it is related to the pre-existing maternal phenotype, and whether it persists long term.

Type: Article
Title: Delivery of small-for-gestational-age neonate and association with early-onset impaired maternal endothelial function
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/uog.17342
Publisher version: https://doi.org/10.1002/uog.17342
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Technology, Life Sciences & Biomedicine, Acoustics, Obstetrics & Gynecology, Radiology, Nuclear Medicine & Medical Imaging, endothelial function, fetal growth restriction, flow mediated dilatation, maternal, postnatal, FLOW-MEDIATED DILATION, CARDIOVASCULAR RISK-FACTORS, BRACHIAL-ARTERY, PREECLAMPSIA, DYSFUNCTION, PREGNANCY, DISEASE, HYPERTENSION, METAANALYSIS, PREDICTION
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10044059
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