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PEDIATRICS Vol. 113 No. 2 February 2004, pp. e77-e80

ELECTRONIC ARTICLE

Abnormal Retinal Vascular Morphology in Young Adults Following Intrauterine Growth Restriction

Ann Hellström, MD, PhD*,{ddagger}, Jovanna Dahlgren, MD, PhD{ddagger}, Karel Marsál, MD, PhD§ and David Ley, MD, PhD||

* Department of Clinical Neurosciences, Section of Ophthalmology
{ddagger} International Pediatric Growth Research Center, Sahlgrenska Academy, Gothenburg, Sweden
§ Department of Obstetrics and Gynecology, Lund University Hospital, Lund, Sweden
|| Department of Pediatrics, Lund University Hospital, Lund, Sweden

Objective. Intrauterine growth restriction (IUGR) resulting in low birth weight for gestational age may predispose one to development of cardiovascular disease later in life. Abnormal fetal blood flow in the presence of fetal growth restriction helps to distinguish infants with true fetal growth impairment from small but normal infants. Our goal was to investigate associations between IUGR with abnormal fetal blood flow and abnormal retinal vascular morphology at 18 years of age.

Methods. A prospective study was performed with 21 subjects with IUGR (abnormal fetal aortic blood flow velocity; birth weight small for gestational age; median birth weight deviation from the population mean of –31% [range: –22% to –42%] and in 23 subjects with birth weight appropriate for gestational age [normal fetal aortic blood flow velocity; median birth weight deviation of –2% (range: –10% to 22%)]). The retinal vessel morphology was evaluated by digital image analysis.

Result. Subjects with IUGR (n = 21) had significantly less retinal vascularization as evidenced by a lower number of vascular branching points (median: 26; range: 20–31) as compared with the subjects who were born appropriate for gestational age (median: 28; range: 26–32). Within the entire group (N = 44), increasing negative birth weight deviation was associated with a reduced number of vascular branching points (r = 0.36.

Conclusion. Our findings show that IUGR with abnormal fetal blood flow is associated with abnormal retinal vascular morphology in young adult life.

Key Words: intrauterine growth restriction • small for gestational age • abnormal vessel morphology

Abbreviations: IUGR, intrauterine growth restriction • SGA, small for gestational age • BFC, blood flow class • AGA, appropriate for gestational age • GH, growth hormone • IGF-I, insulin like growth factor 1

Received for publication May 19, 2003; Accepted Sep 30, 2003.




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