Serum Lipid Profile in Newborns with Intrauterine Growth Retardation and Its Comparison with Appropriate for Gestation Age Newborns
Asian Journal of Pediatric Research,
Page 12-23
DOI:
10.9734/ajpr/2022/v9i130256
Abstract
Background: Newborns with intrauterine growth retardation (IUGR) are known to permanently change their physiology and metabolism to adapt to limited supply of nutrients in utero. These programmed changes can later be the cause for the origin of diseases like coronary artery disease, diabetes mellitus and hypertension. If the premature development of cardiovascular risk factors can be anticipated during childhood, future events can be prevented effectively by taking appropriate measures.
Objective of the Study: To study serum lipid profile of newborns with IUGR and Appropriate for Gestation Age(AGA) newborns and compare them.
Methodology: This cross sectional study was conducted from February 2018 to September 2018 in the department of Neonatology, BSMMU, Dhaka, Bangladesh. Newborn who met the inclusion criteria, information regarding antenatal, natal and postnatal history were recorded in a data collection form after taking consent from the parents/guardians. Weight, length, OFC were taken along with other clinical examination. Serum samples of infant with intrauterine growth retardation and matched group of Appropriate for Gestation Age newborns were collected within 24 hours of postnatal age before starting feed and sent to Biochemistry laboratory of BSMMU and analyzed for lipid profile which included serum cholesterol, Triglyceride, Low Density Lipoprotein(LDL) and High Density Lipoprotein (HDL).All data were recorded in a preformed questionnaire and data was analyzed by statistical package for social sciences (SPSS) version 20. Quantitative data were expressed as mean\(\pm\) SD and categorical data were presented as proportion. All quantitative variables were compared by unpairedt-test; categorical variables were compared by Chi-square test or Fisher’s exact test. P < 0.05 was considered as significant. Pearson correlation was done to see the correlation between gestation age and lipid profile in both IUGR and AGA newborns.
Results: Total population included 43 IUGR newborns and 43 AGA newborns who were matched by gestational age and sex. No significant difference was seen among both the groups based on demography except for birth weight which was lower in IUGR newborns than AGA newborns (1398.02\(\pm\) 307.14 vs 1777.91\(\pm\) 551.2 , p=<0.001). It was observed that serum triglyceride level in IUGR group was significantly higher than those in AGA group (90.23 \(\pm\) 48.16 vs. 70.13 \(\pm\) 27.76, p=0.020). Serum HDL-c level was found to be significantly lower in IUGR group as compared to AGA group (20.62\(\pm\) 8.88 vs. 26.95 \(\pm\) 7.91, p=0.001). There was a significant negative correlation between gestation age and serum LDL-c level in IUGR infants(r = -0.334).
Conclusion: As compared to AGA newborns, IUGR infants had significantly higher levels of triglyceride and lower levels of HDL-c. Significant negative correlation was observed between gestation age LDL-c in IUGR newborns.
Keywords:
- Serum lipid profile
- newborn
- IUGR
- gestation age
How to Cite
References
Grant ID, Giussani DA, Aiken CE. Blood pressure and hypertensive disorders of pregnancy at high altitude: a systematic review and meta-analysis. American Journal of Obstetrics & Gynecology MFM. 2021;3(5):100400.
Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A, Vermont. Oxford Network, Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. American Journal of Obstetrics and Gynecology. 2000;182(1):198-206.
Resnik R. Intrauterine growth restriction. Obstetrics & Gynecology. 2002;99(3):490-496.
Palinski W, Napoli C. Impaired fetal growth, cardiovascular disease, and the need to move on. 2008;341-343.
Ströbel, Philipp, et al. Thymoma and thymic carcinoma: an update of the WHO Classification 2004. Surgery Today. 2005;35(10):805-811.
Paul S, Akter R, Aftab A, Khan AM, Barua M, Islam S, Sarker M. Knowledge and attitude of key community members towards tuberculosis: mixed method study from BRAC TB control areas in Bangladesh. BMC Public Health. 2015; 15(1):1-8.
Barker DJ. Fetal origins of coronary heart disease. BMJ. 1995;311(6998):171-174.
Sankaran S, Kyle PM. Aetiology and pathogenesis of IUGR. Best Practice & Research Clinical Obstetrics & Gynaecology. 2009;23(6):765-777.
Gomella TL, Cunningham MD, Eyal FG, Tuttle DJ. (Eds). Neonatology: Management, Procedures, On-call problems, Diseases and Drugs, 7th Edn, McGraw Hill education, New York; 2013.
Gluckman PD, Hanson MA. The developmental origins of the metabolic syndrome. Trends in Endocrinology & Metabolism 2004;15(4):183-187.
Weyer C, Tataranni PA, Bogardus C, Pratle RE. Insulin resistance and insulin secretory dysfunction are independent predictors of worsening of glucose tolerance during each stage of type 2 diabetes development’. Diabetes Care. 2001;24(1):89-94.
Kimm SY. Fetal origins of adult disease: the Barker hypothesis revisited- 2004. Current Opinion in Endocrinology 2004. Diabetes and Obesity. 2004;11(4):192-196.
Barkerb DJP, Clark PM. Fetal undernutrition and disease in later life. Reviews of Reproduction. 1997;2(2):105-112.
Murtaugh MA, Jacobs DR, Moran A, Steinberger J, Sinaiko AR. Relation of birth weight to fasting insulin, insulin resistance, and body size in adolescence. Diabetes Care. 2003;26(1):187-192.
Steinberger J. Insulin resistance and cardiovascular risk in the pediatric patient. Progress in Pediatric Cardiology. 2001;12(2):169-75.
Barker DJ, Martyn CN, Osmond C, Hales CN, Fall CH. Growth in utero and serum cholesterol concentrations in adult life. British Medical Journal. 1993;307(6918): 1524-1527.
Khalid S, Beg K, Ambad R. Study of lipid profile in cases of intrauterine growth retardation. International Journal of Medical Research Professionals. 2016; 2(5):97-102.
Jadhao AN, Barapatre AR, Lokhande MC, Ramteke T. Atherogenic lipid profile of intrauterine growth retarded newborns. International Journal of Advances in Medicine. 2016;3(3):748-754.
Katragadda T, Mahabala RS, Shetty S, Baliga S. Comparison of cord blood lipid profile in preterm small for gestational age and appropriate for gestational age newborns. Journal of Clinical and Diagnostic Research: JCDR. 2017;11(1): p.SC05.
Pecks U, Brieger M, Schiessl B, Bauerschlag DO, Piroth D, Bruno B, et al. Maternal and fetal cord blood lipids in intrauterine growth restriction. Journal of Perinatal Medicine. 2012;40(3):287-296.
Pecks U, Caspers R, Sosnowsky K, Maass N, Rath W, Huppertz B. Oxidized LDL particles in the placenta of intrauterine growth restriction (IUGR) subgroups. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 2013;3(2):78-79.
Hossain MA, Islam MN, Shahidullah M, Akhter H. Serum triglyceride level in IUGR babies and its comparison with preterm AGA and term normal babies. Mymensingh Medical Journal: MMJ. 2006;15(2):180-182.
Kaser S, Ebenbichler CF, Wolf HJ, Sandhofer A, Stanzl U, Ritsch A, Patsch JR. Lipoprotein profile and cholesteryl ester transfer protein in neonates. Metabolism-Clinical and Experimental. 2001;50(6):723-728.
Inazu A, Jiang XC, Haraki T, Yagi K, Kamon N, Koizumi J, Mabuchi H, Takeda R, Takata K, Moriyama Y. Genetic cholesteryl ester transfer protein deficiency caused by two prevalent mutations as a major determinant of increased; 1994.
Donegá S, Oba J, Maranhão RC. Concentration of serum lipids and apolipoprotein B in newborns. Arquivosbrasileiros de Cardiologia. 2006; 86(6):419-424.
Nayak CD, Agarwal V, Nayak DM. Correlation of cord blood lipid heterogeneity in neonates with their anthropometry at birth. Indian Journal of Clinical Biochemistry. 2013;28(2):152-157.
Soleimani H, Seyyed-Esfahani M, Shirazi MA. Designing and planning a multi-echelon multi-period multi-product closed-loop supply chain utilizing genetic algorithm. The International Journal of Advanced Manufacturing Technology. 2013;68(1):917-931.
Anderson MA. The relationship between maternal nutrition and child growth in rural India’, Doctoral dissertation, Tufts University, Medford, Mass, USA; 1989.
Martins IJ. Apelin and Sirtuin 1 dysregulation induce endocrine and metabolic disorders in chronic disease. J Endocrinol. 2017;219:R13-R35.
Badiee Z, Kelishadi R. Cord blood lipid profile in a population of Iranian term newborns. Pediatric Cardiology. 2008; 29(3):574-579.
Finken MJ, Keijzer-Veen MG, Dekker FW, Frolich M, Walther FJ, Romijn JA, et al. Antenatal glucocorticoid treatment is not associated with long-term metabolic risks in individuals born before 32 weeks of gestation. Archives of Disease in Childhood-Fetal and Neonatal Edition; 2008.
DeVries WB, Karemaker R, Mooy NF, Strengers JL, Kemperman H, Baerts W, et al. Cardiovascular follow-up at school age after perinatal glucocorticoid exposure in prematurely born children: perinatal glucocorticoid therapy and cardiovascular follow-up. Archives of Pediatrics & Adolescent Medicine. 2008; 162(8):738-744.
Doyle LW, Ford GW, Davis NM, Callanan C. Antenatal corticosteroid therapy and blood pressure at 14 years of age in preterm children. Clinical Science. 2000; 98(2):137-142.
Kelly BA, Lewandowski AJ, Worton SA, Davis EF, Lazdam M, Francis J, Neubauer S, et al. Antenatal glucocorticoid exposure and long-term alterations in aortic function and glucose metabolism. Pediatrics. 2012; peds-2011.
Norberg H, Stålnacke J, Nordenström A, Norman M. Repeat antenatal steroid exposure and later blood pressure, arterial stiffness, and metabolic profile. The Journal of Pediatrics. 2013;163(3): 711-716.
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