Early fetal phase linked to cardiac risk factors
By Ilaria Ceglia
Occasionally here at The Incubator, we like review an empirical article from the scientific literature that is openly accessible to all of our readers. This post reviews the following article:
Jaddoe, V. W., de Jonge, L. L., Hofman, A., Franco, O. H., Steegers, E. A., & Gaillard, R. (2014). First trimester fetal growth restriction and cardiovascular risk factors in school age children: population based cohort study. BMJ: British Medical Journal, 348.
The first trimester of pregnancy is critical for the development of fetal cardiovascular and metabolic organs including the heart, and may also permanently affect their structure and function throughout childhood and adulthood. However, despite a large amount of research, questions remain regarding the link between early fetal life and later development of cardiac risk factors.
Vincent Jaddoe and colleagues conducted a nested prospective cohort study that included 1,184 children, followed from just after conception to age six. Crown-to-rump length (a common way to measure the size of a fetus, equal to the length from the top of the head to the bottom of the buttocks) was used as a first trimester growth outcome measure in all children whose mothers had a known first day of her last menstrual period and a regular cycle.
At age six, Jaddoe and colleagues measured the children’s body mass index (BMI) and a large number of other health measures including their total and abdominal fat distribution, their blood pressure, and the concentrations of cholesterol, triglycerides, insulin, and C peptide in their blood. In their statistical models, the researchers discovered that greater first trimester fetal crown-to-rump length was associated with decreased risk factors for cardiovascular disease in childhood, such as lower total fat mass, lower diastolic blood pressure, and lower cholesterol. According to these same models, the link between fetal crown-to-rump length and childhood total fat mass was fully explained by childhood BMI.
Additionally, school age children with clustering of cardiovascular risk factors showed a smaller first trimester fetal crown to rump length compared to those without clustering, and a lower fetal weight in the second and third trimester but higher weight growth from 6 months and up, suggesting that first trimester fetal crown to rump length is associated with cardiovascular risk factors in childhood.
These observations highlighted that early fetal life influence the development of cardiovascular disease later in life.