Adverse Fetal Environment Is a Cardiovascular Risk Factor

Even though a baby may be healthy at birth, if it has been exposed to these circumstances during the pregnancy, this information must be made available, and the child must be provided with appropriate follow-up, according to researchers.

This topic was addressed at a round table discussion held during the 69th Conference of the Spanish Association of Pediatrics. The discussion touched on key advances in the field of pediatric cardiology.


Intrauterine Growth Restriction

Certain characteristics define an adverse fetal environment. Deiros noted that the epigenetic changes brought on in this setting that could affect fetal cardiac well-being could involve maternal disorders such as poorly controlled diabetes or conditions with more complex hemodynamics, as in twin-to-twintransfusion syndrome, which can occur in twin pregnancies.

"However, intrauterine growth restriction has been studied the most and is most closely linked with the development of cardiovascular risk in the future that is higher in comparison to the risk experienced by the child's peers. Evidence suggests that fetuses with this history may have an increased likelihood of developing cardiovascular disease, both in childhood and adulthood.

Prenatal Diagnosis

The physician pointed out that from these case studies, the benefits of implementing prenatal diagnosis can be fully appreciated. 

Tailored Interventions

To illustrate what this approach involves, the expert posed the scenario of children who are born with transposition of the great arteries that requires specialized cardiac management and measures such as scheduling delivery at a tertiary hospital to ensure that a cardiologist, an on-call hemodynamic specialist, and a cardiac surgeon are present.

She also noted as significant advances the establishment of the fetal cardiac ultrasound teams of today, and especially the level of medical education, both for obstetricians and pediatric cardiologists.