Arterial wall thickness and blood pressure in children who were born small for gestational age: correlation with umbilical cord high-sensitivity C-reactive protein

Arch Dis Child. 2010 Jan;95(1):31-4. doi: 10.1136/adc.2008.150326. Epub 2009 Sep 21.

Abstract

Background: Small for gestational age (SGA) infants have an increased risk of later cardiovascular disease. At birth, high sensitivity-C reactive protein (hs-CRP), a prognostic marker of cardiovascular disease, is significantly higher in SGA than in appropriate for gestational age (AGA) infants.

Aim: To measure aortic and carotid intima-media thickness (aIMT, cIMT) and blood pressure (BP) in children (aged 3-5 years) who were born SGA and AGA, and to assess the correlation between hs-CRP concentrations obtained at birth and these haemodynamic variables.

Methods: Umbilical cord hs-CRP concentrations were obtained in 38 neonates. In the same subjects aged 3-5 years, aIMT and cIMT were measured by high-resolution ultrasound scan, in the dorsal arterial wall. Anthropometric variables and BPs were obtained for each child.

Results: Maximum (median 0.700 mm, range 0.500-1.080 vs 0.650 mm, 0.400-0.860; p = 0.32) aIMTs were similar between children who were born SGA (n = 17) and AGA (n = 21), respectively. Concentrations of hs-CRP were not correlated with IMTs. In children who were born SGA, systolic BP was significantly correlated with umbilical cord hs-CRP concentrations (r = 0.60; p = 0.009).

Conclusions: Children who were born SGA have a higher, although not significant, aortic thickening than those who were born AGA. Umbilical cord hs-CRP concentrations do not seem to be involved in this process. Instead, hs-CRP concentrations were significantly related to systolic BP values in children who were born SGA, suggesting that hs-CRP at birth could be associated with sympathetic system hyperactivity and with the stress response during childhood.

MeSH terms

  • Anthropometry / methods
  • Aorta, Abdominal / anatomy & histology*
  • Aorta, Abdominal / diagnostic imaging
  • Biomarkers / blood
  • Birth Weight / physiology
  • C-Reactive Protein / analysis*
  • Carotid Arteries / anatomy & histology*
  • Carotid Arteries / diagnostic imaging
  • Child, Preschool
  • Female
  • Fetal Blood / chemistry
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Small for Gestational Age / blood
  • Infant, Small for Gestational Age / physiology*
  • Male
  • Retrospective Studies
  • Tunica Intima / anatomy & histology
  • Tunica Intima / diagnostic imaging
  • Tunica Media / anatomy & histology
  • Tunica Media / diagnostic imaging
  • Ultrasonography
  • Umbilical Cord / chemistry*

Substances

  • Biomarkers
  • C-Reactive Protein