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Impact of perinatal cardiac dysfunction on offspring's cardiovascular health in fetal growth restriction and gestational diabetes: a longitudinal follow up study from the term fetus to the neonate and infant

Grant number: 19/01280-3
Support type:Scholarships abroad - Research
Effective date (Start): September 02, 2019
Effective date (End): September 01, 2020
Field of knowledge:Health Sciences - Medicine - Maternal and Child Health
Principal Investigator:Conrado Milani Coutinho
Grantee:Conrado Milani Coutinho
Host: Baskaran Thilaganathan
Home Institution: Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP (HCMRP). Secretaria da Saúde (São Paulo - Estado). Ribeirão Preto , SP, Brazil
Local de pesquisa : St George's University Hospitals, England  

Abstract

High-risk pregnancies affected by fetal growth restriction (FGR) and gestational diabetes mellitus (GDM) have an impact on fetal and long-term cardiovascular function, increasing the risk of adverse pregnancy outcomes and cardiovascular morbidity and mortality in adult life.The objective of this study was to investigate the evolution of perinatal cardiac alterations in the geometric and functional ultrasonographic parameters and the predictivity of changes in cardiac ultrasonographic indices and biomarkers in cord blood of gestations with FGR and GDM until the 6th month of life.A prospective longitudinal cohort study will be conducted with inclusion of 100 normal pregnant women, whose results will be compared to those of 80 with FGR and 80 with GDM. Echocardiograms will be performed at the end of gestation, with 48-72 hours and at 3-6 months of life, with the objective of evaluating cardiac function and anatomy by conventional methods and with the innovative fetal HQ system to obtain the sphericity index of 24 segments and strain rate. There will be collection of metabolic, cardiac dysfunction and placental subperfusion biomarkers in cord blood.This study aims to improve the understanding of the impact of abnormal perinatal cardiac adaptation on the cardiac and metabolic health of the offspring of pregnancies affected by FGR and GDM and may also have relevance in the optimization of the perinatal and short-term cardiovascular outcomes of these pathological pregnancies using the fetal period as a potential window for future interventions.