Latini, G; De Mitri, B; Del Vecchio, A; Chitano, G; De Felice, C; Zetterstrom, R
Background:Fetal growth retardation has been associated with diseases and disorders later in life. It has been suggested that this is caused by the impaired development of abdominal organs. Besides general malnutrition of the fetus, preferential bloodflow to the heart and brain may further deprive organs, such as liver, spleen, and kidney, of nutrients. As a result these organs may not develop properly, thus predisposing to higher morbidity and mortality rates, as well as a possible contribution towards late sequelae, such as hypertension, cardiovascular disease, osteoporosis, schizophrenia, depression, breast cancer, and the polycystic ovary syndrome in adulthood. The aim of this study was to investigate the effects of maternal undernutrition on abdominal organs growth, comparing kidney, spleen and liver sizes in adequate for gestational age (AGA) and small for gestational age (SGA) infants. Methods: A total of 25 AGA [M:14, F:11; gestational age: 34.5 +/-5.02 (range:25 and #150;40) weeks; birth weight: 2318+/-965 g (range: 680-3800)] and 25 SGA infants [M:8, F:17; gestational age: 34.2 +/- 4.2 (range:25 and #150;39) weeks; birth weight: 1562+/-644 g (range: 440-2400)] participated to the study. Intraabdominal organs sizes (liver, kidney, spleen) were determined using ultrasonography during neonatal period. Liver, kidney, and spleen volumes were estimated using the standard formula for ellipsoid (longitudinal x antero-posterior x transverse diameter x and lt;240/6). Liver/kidney, liver/spleen, and kidney/spleen ratios were also determined. For better comparisons the infants were subdivided into three gestational age groups ( and lt;30, 30 and #150;36, 37 and #150;40 weeks). Results: Kidney and liver volumes were significantly different between the two groups at all ages (p and lt;=0.0018, p and lt;=0.029, respectively); while spleen volume differed in the 37 and #150;40 weeks group (p=0.0002). The correlation liver volume vs. birth weight was significantly different between SGA and AGA infants (r=0.56 vs. 0.84, p=0.04). On the other hand, the ratios among intraabdominal organs were unchanged (p and gt;=0.15). Conclusion: Our findings support the concept that abdominal organs development mainly for liver and kidney is impaired in intra-uterine growth-retarded infants and may contribute to impaired organ function, thus possibly predisposing to late sequelae in childhood and adulthood. As a consequence, fetal and #147;programming and #148;may increase susceptibility to diseases later in life.