Cardiovascular risk factors in healthy women with previous small for gestational age infants

J Obstet Gynaecol Res. 2011 Oct;37(10):1397-404. doi: 10.1111/j.1447-0756.2011.01547.x. Epub 2011 May 22.

Abstract

Aim: To investigate whether healthy women with a previous pregnancy complicated by a small for gestational age (SGA) infant have normal endothelial function, carbohydrate and lipid metabolism, and normal inflammation parameters.

Material and methods: Brachial artery flow-mediated dilatation (FMD, endothelium-dependent) was measured in 16 subjects with previous SGA, and in 15 controls (CTR) with previous normal pregnancies. Lipid panel, glucose, insulin, tumor necrosis factor alpha (TNF-alpha), soluble intercellular adhesion molecule-1 (s-ICAM), soluble vascular (s-VCAM-1) adhesion molecule-1 (s-VCAM-1), and androgens were also measured.

Results: FMD was reduced in women with previous SGA compared to controls (P < 0.0001). SGA women showed increased insulin resistance (P < 0.0001), s-ICAM-1 (P = 0.008), TNF-alpha (P = 0.02), testosterone (P = 0.03), and diastolic blood pressure (P = 0.01) than CTR.

Conclusion: Endothelial dysfunction, reduced insulin sensitivity and subclinical inflammation are present in otherwise healthy women with previous SGA. These abnormalities show that the presence of a SGA infant in the obstetric history should be considered as a risk factor for cardiovascular disease later in life.

MeSH terms

  • Adult
  • Blood Flow Velocity / physiology*
  • Blood Glucose
  • Blood Pressure / physiology
  • Brachial Artery / physiopathology*
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / physiopathology
  • Endothelium, Vascular / physiopathology*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Intercellular Adhesion Molecule-1 / blood
  • Intercellular Adhesion Molecule-1 / cerebrospinal fluid
  • Lipids / blood
  • Pregnancy
  • Risk Factors
  • Tumor Necrosis Factor-alpha / blood
  • Vascular Cell Adhesion Molecule-1 / blood
  • Vasodilation / physiology*

Substances

  • Blood Glucose
  • Lipids
  • Tumor Necrosis Factor-alpha
  • Vascular Cell Adhesion Molecule-1
  • Intercellular Adhesion Molecule-1