Fetal programming: Evaluation of cardiovascular remodeling in late-onset small-for-gestational-age fetuses and prediction of adverse birth and intermediate-term cardiovascular outcome- CURIOSA study

Project start
Institution: Frauenklinik, Klinikum rechts der Isar der Technischen Universität München
Applicant: PD Dr. Silvia M. Lobmaier
EKFS funding line: first application
Dr. Lobmaier performing fetal cardiac function measurements

Clinical studies over the last decade have demonstrated that on average SGA (small for gestational age) fetuses show signs of cardiovascular remodeling and have higher postnatal cardiovascular risks. Newer findings suggest that SGA induces primary cardiac and vascular changes that could explain the increased predisposition to cardiovascular disease in adult life even.
Additionally, SGA fetuses might show delayed autonomic nervous system maturation as this already has been shown for fetuses with severe placental insufficiency. Consequently, the clinical need has emerged to develop additional markers to predict these outcomes. 

Our aim was the prediction of cardiovascular outcome at 12 months of age. Therefore we performed follow-up examinations (ultrasound, CTG, ECG from mother and fetus) during pregnancy and examination of cord blood and placenta after delivery. Additionally, children were seen at 12 months of age by a pediatric cardiologist. 

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