The effect of intrauterine growth retardation on the development of renal nephrons
| Autor: | P. H. Sargent, M. R. J. Lynch, D. van Velzen, C. V. Howard, S. A. Hinchliffe |
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| Rok vydání: | 1992 |
| Předmět: |
medicine.medical_specialty
Renal function Nephron Pregnancy Internal medicine medicine Birth Weight Humans Prospective Studies Fetal Death reproductive and urinary physiology Preterm delivery Fetus Fetal Growth Retardation Growth retardation Obstetrics business.industry Infant Newborn Outcome measures Infant Obstetrics and Gynecology Gestational age Nephrons female genital diseases and pregnancy complications Endocrinology medicine.anatomical_structure Female business Complication |
| Zdroj: | BJOG: An International Journal of Obstetrics and Gynaecology. 99:296-301 |
| ISSN: | 1471-0528 1470-0328 |
| DOI: | 10.1111/j.1471-0528.1992.tb13726.x |
| Popis: | OBJECTIVE To investigate the effect of Type II (asymmetrical) intrauterine growth retardation (IUGR) on renal development. DESIGN A prospective descriptive study. SETTING Department of Fetal and Infant Pathology, Liverpool Children's Hospital. SUBJECTS Six (severely) affected IUGR stillbirths of known gestational age with a control group of stillbirths with birthweight greater than 10th centile, and eight liveborn IUGR infants who died within a year of birth with a control group of appropriately grown infants who died within a year of birth (postnatal groups). TECHNIQUES The kidneys from all the groups studied were analysed using unbiased, reproducible and objective design-based stereological techniques. MAIN OUTCOME MEASURES Total renal nephron (glomerular) numbers and average volumes of total nephron and cortical and medullary nephron segments. RESULTS Nephron number estimates lay below the control group's 5% prediction limit in five out of the six growth-retarded stillbirths, and were significantly (P less than 0.005, IUGR at 65% of the control mean) reduced in the postnatal group. Estimates of nephron (segment) volume did not differ between control and IUGR groups. CONCLUSIONS Type II intrauterine growth retardation may exert a profound effect on renal development. The reduced nephron number at birth, together with the lack of any early postnatal compensation in either nephron number or nephron size, emphasizes the need for vigorous antenatal surveillance for IUGR and consideration of elective preterm delivery of affected fetuses. A systematic review of other organs, which develop in a similarly rapid fashion during the late intrauterine period, is indicated by this work. With one exception, all birthweights in the growth-retarded groups were below the third centile, thus the precise quantitative relation between progressive IUGR and renal function requires further assessment. |
| Databáze: | OpenAIRE |
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