Abstract
Background/aims: Fetal growth retardation may be associated with diseases and disorders in later life. This risk may be due to some impairment of the development of such organs as liver and kidney. In addition to general malnutrition of the fetus, preferential blood flow to the brain and the heart may furthermore deprive such organs as liver, spleen, and kidney on oxygen and macro- and micronutrients. As a consequences these organs may not develop normally, which predisposes to impaired outcome of the fetus. Persisting metabolic dysfunction may then cause such diseases as hypertension, cardiovascular disease, osteoporosis, schizophrenia, mental depression, breast cancer, and polycystic ovary syndrome in adult age. The aim of this study was to investigate the effects of maternal undernutrition on the growth of some abdominal organs. The size of the kidneys, spleen and liver in adequate for gestational age newborn infants (AGA) has been compared with that in small for gestational age (SGA) infants.
Methods: A total of 25 randomly selected AGA [M:14, F:11; gestational age: 34.5± 5.02 (range:25– 40) weeks; birth weight: 2318±965 g (range: 680–3800)] and 25 SGA infants [M:8, F:17; gestational age: 34.2±4.2 (range:25–39) weeks; birth weight: 1562±644 g (range: 440–2400)] entered the study. The sizes of the liver, kidneys and spleen were determined by the use of ultrasonography. The volumes were estimated using the standard ellipsoid formula (longitudinal x anteroposterior x transverse diameter x <240/6). Liver/kidney, liver/spleen, and kidney/spleen ratios were determined in three gestational age groups of the infants (<30, 30–36, 37– 40 weeks).
Results: The volumes for the kidneys and the liver differed significantly between AGA and SGA infants in all 3 groups (p≤ 0.0018, p≤0.029, respectively); whereas the spleen volume only differed in the 37– 40 weeks group (p=0.0002). The correlation between the liver volume and the birth weight differed significantly between SGA and AGA infants (r=0.56 vs. 0.84, p=0.04). On the other hand, the ratios between the 3 organs were the same in all groups (p≥0.15).
Conclusions: Our findings support the view that fetal growth of the liver and the kidneys is impaired in intra-uterine growth-retarded infants. Impaired fetal development of these organs may cause metabolic dysfunction which predisposes to diseases included in the so-called metabolic syndrome or syndrome X. Fetal environmentally caused “programming” may increase the risk of functional defects and diseases in later life.
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Latini, G., De Mitri, B., Del Vecchio, A. et al. 146 Abdominal Organ Growth in Intrauterine Growth Retardation: Fetal “Programming” Causing “Metabolic Syndrome” In Adult Age. Pediatr Res 56, 489 (2004). https://doi.org/10.1203/00006450-200409000-00169
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DOI: https://doi.org/10.1203/00006450-200409000-00169
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