Infants with fetal growth restriction show persistent myocardial dysfunction at 1 year

A prospective longitudinal study followed infants with fetal growth restriction (FGR) and appropriate-for-gestational-age controls through 12 months. Cardiac dimensions largely normalized in the FGR groups, but echocardiographic strain measures remained impaired, with right ventricular dysfunction particularly evident in early-onset FGR.

Cardiac dimensions normalized by 12 months in FGR groups.
Strain and strain-rate measures remained impaired.
Right ventricular dysfunction was most evident in early-onset FGR.
Long-term cardiovascular outcomes were not reported.

This prospective longitudinal study evaluated cardiac structure and function in neonates with fetal growth restriction (FGR) and appropriate-for-gestational-age (AGA) controls. Of 128 FGR and 64 AGA neonates enrolled, 39 with early-onset FGR, 47 with late-onset FGR, and all 64 controls completed follow-up at one year. Assessments included conventional echocardiography, tissue Doppler imaging, and speckle-tracking echocardiography.

At birth, infants with FGR had smaller cardiac dimensions than AGA controls. By 12 months, both FGR groups had catch-up growth and normalized left ventricular dimensions and wall thickness. However, global longitudinal strain and strain-rate indices remained significantly impaired across follow-up. Right ventricular dysfunction was evident at 12 months, particularly among infants with early-onset FGR.

The findings indicate persistent subclinical myocardial differences despite apparent structural catch-up. The study does not establish whether these echocardiographic changes lead to later cardiovascular disease or whether surveillance improves outcomes. The authors suggest longitudinal cardiac surveillance, but the supplied report does not specify a surveillance approach or demonstrate clinical benefit.

In practice

In infants with antenatally and postnatally confirmed fetal growth restriction, cardiac dimensions may normalize by 12 months while echocardiographic strain indices remain impaired; right ventricular dysfunction was reported particularly in early-onset FGR. These findings support concern about persistent subclinical differences, but the study does not show that the imaging findings predict later cardiovascular disease or that cardiac surveillance changes outcomes. The results alone do not establish a specific surveillance schedule or justify a change in routine clinical management.

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Source

Pediatric Research: Persistent subclinical myocardial dysfunction among infants with Fetal growth restriction at one year of age ↗

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