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A detailed echocardiographic evaluation of ventricular functions in stable full term small for gestational age babies

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Abstract

Purpose

SGA infants with fetal growth restriction have reduced ability to adapt themselves to the postnatal life because of certain epigenetic changes in cardiac function. The aim of the present study is to assess and compare the cardiac functions of fetal growth restricted SGA newborns to the term stable AGA newborns, and evaluate any differences in the cardiac functions during the postnatal transitional circulation.

Method

This observational study was conducted at a multispecialty tertiary care hospital in Western India from June to November 2021. The newborns were evaluated using bedside echocardiography at 24–48 h and repeat screening after 48 h. The echocardiographic assessment of the systolic function was done using EF, FS, FAC and TAPSE; diastolic function using E/A wave ratio and global functioning using LV MPI.

Result

Twnety-four babies were included in cases and 30 in the control arm of the study. Maternal and newborn characteristics were comparable between the two groups. FS, EF for left ventricle and TAPSE, FAC for right ventricular systolic function were significantly lower in SGA group (p = 0.02, 0.02, 0.00 and 0.01; respectively). The current study revealed a lower tricuspid E/A ratio and higher mitral E/A ratio with a significant difference beyond 48 h in the first week of life (p value 0.00). Left ventricular MPI was significantly higher in SGA infants compared to AGA infants during two subsequent readings in immediate newborn period with p values 0.01 and 0.02 respectively. The subgroup analysis revealed that fetal growth-restricted neonates with absent end-diastolic flow had a greater impact on ventricular functions.

Conclusion

Present study showed a significant systolic and diastolic dysfunction during initial newborn period in growth restricted SGA infants.

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Authors and Affiliations

  1. Department of Neonatology, Bharati Vidyapeeth University Medical College, Hospital and Research Center, Pune, Maharashtra, India

    Arjun Verma, Pradeep Suryawanshi, Aditya Kallimath, Pari Singh & Reema Garegrat

  2. Department of Neonatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India

    Chinmay Chetan

  3. Department of Research, Bharati Vidyapeeth University Medical College, Hospital and Research Center, Pune, Maharashtra, India

    Gauri Oka

  4. Department of Pediatrics, Division of Neonatology, Loma Linda University School of Medicine, Loma Linda, CA, 92354, USA

    Yogen Singh

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  1. Arjun Verma
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Correspondence to Pradeep Suryawanshi.

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Funding

The authors declare that no funds, grants, or other support were received for conducting this study and preparation of this manuscript.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Author contributions

All authors made substantial contributions to the conception or design of the work. Acquisition, analysis and interpretation of the data was done by Arjun Verma. The first draft of the manuscript was written by Arjun Verma. Gauri Oka and Yogen Singh revised critically for important intellectual content. Pradeep Suryawanshi approved the version to be published. All authors read and approved the final manuscript.

Ethics approval

This observational study was approved by Institutional ethics committee of Bharati Vidyapeeth medical college and certificate was granted on 7th May, 2021 under the reference number: BVDUMC/IEC/20.

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Verma, A., Suryawanshi, P., Chetan, C. et al. A detailed echocardiographic evaluation of ventricular functions in stable full term small for gestational age babies. J Ultrasound 26, 117–127 (2023). https://doi.org/10.1007/s40477-022-00691-2

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