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Fetale Wachstumsrestriktion und Herz-Kreislauf-Erkrankungen im Erwachsenenalter

Fetal growth restriction and adult cardiovascular diseases

Zusammenfassung

Epidemiologische Untersuchungen weisen auf einen Zusammenhang von intrauteriner Wachstumsrestriktion und arterieller Hypertonie beim Menschen hin. Tierversuche bestätigen, dass eine von der genetischen Grundausstattung unabhängige inverse Relation zwischen Geburtsgewicht und arteriellem Blutdruck besteht. Der Fet adaptiert sich an ein gestörtes intrauterines Milieu mit metabolischen, endokrinen und hämodynamischen Veränderungen, die in ihrer Gesamtheit zu einer Blutdruckerhöhung führen und über die Neugeborenenzeit bis in die Erwachsenenzeit persistieren könnten. Falls die intrauterine Wachstumsrestriktion als unabhängiger Risikofaktor für Herz-Kreislauf-Erkrankungen bestätigt wird, könnten sich in der Zukunft mannigfaltige Ansätze zur primären und früh einsetzenden Prophylaxe dieser Erkrankungen bei entsprechend exponierten Neugeborenen ergeben.

Abstract

Epidemiological studies in different populations have revealed an association between low birth weight and cardiovascular disease later in life. Animal studies confirm that placental insufficiency results in low birth weight offspring destined to develop hypertension, the main risk factor for atherosclerosis and cardiovascular disease in later life. The fetus adapts towards an adverse intrauterine environment with metabolic, endocrine and hemodynamic changes. It is hypothesized that these changes persist after delivery and predispose the individual to hypertension and atherosclerosis. Cardiovascular disease is by far the most relevant factor in overall mortality in Germany. If intrauterine growth restriction is confirmed to be an independent risk factor for cardiovascular disease, this knowledge will have a great impact on health care systems and on the primary prophylaxis of cardiovascular diseases in persons born with intrauterine growth restriction.

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Correspondence to PD Dr. E. Beinder.

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Beinder, E. Fetale Wachstumsrestriktion und Herz-Kreislauf-Erkrankungen im Erwachsenenalter. Gynäkologe 40, 241–247 (2007). https://doi.org/10.1007/s00129-007-1962-2

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Schlüsselwörter

  • Plazentainsuffizienz
  • Fetalzeit
  • Programmierung von Erkrankungen
  • Diabetes mellitus
  • Arteriosklerose

Keywords

  • Placental insufficiency
  • Fetal origin
  • Programming of diseases
  • Diabetes mellitus
  • Arteriosclerosis