The effect of acute maternal hypoglycaemia on fetal cardiovascular control

Cleal, J.K., Hanson, M.A., Gardiner, H.M. and Green, L.R. (2007) The effect of acute maternal hypoglycaemia on fetal cardiovascular control. Early Human Development, 83, (supplement 1), p.S88. (doi:10.1016/S0378-3782(07)70191-3).


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Aims: To investigate the effect of acute maternal hypoglycaemia
on fetal cardiovascular (CV) function, as a sub-optimal environment
in utero has been implicated in the development of CV disease in
adult life.

Subjects: Fetal sheep (n = 7) were studied in utero at 125 and 126
days gestational age (dGA, term = 147 days) following implantation
of vascular catheters and an umbilical cord occluder at 119 dGA.

Study design: Fetal CV parameters were measured during a
maternal saline (day 125) and insulin (day 125) infusion. Fetal
CV function was assessed by: (a) generating a dose response
curve to angiotensin II; (b) a 90 sec total umbilical cord occlusion;
(c) administration of phenylephrine to assess baroreflex function.

Outcome measures: (a) Area under the mean arterial blood
pressure (MAP) response (AUC) to increasing doses of angiotensin II;
(b) MAP and heart rate (HR) response to cord occlusion;
(c) sensitivity and operating point of the baroreflex response.
Results: Maternal insulin infusion resulted in maternal and fetal
hypoglycaemia. (a) The angiotensin II MAP AUC was not affected
by hypoglycaemia. (b) The increase in MAP and decrease in
HR following a 90 sec cord occlusion was not affected by
hypoglycaemia. (c) Hypoglycaemia resulted in reduced fetal
baroreflex sensitivity (P <0.05, paired t test).

Conclusions: Our finding of reduced fetal baroreflex sensitivity
during fetal hypoglycaemia indicates altered CV homeostatic
mechanisms. Such fetal adaptations to a poor intrauterine
environment could contribute towards the development of altered
cardiovascular phenotype in adult life.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1016/S0378-3782(07)70191-3
Additional Information: 5th International Congress on Developmental Origins of Health & Disease (Poster P1-21)
ISSNs: 0378-3782 (print)
Related URLs:
Keywords: cardiovascular, fetal, maternal
Subjects: R Medicine > RG Gynecology and obstetrics
R Medicine
Divisions : University Structure - Pre August 2011 > School of Medicine
ePrint ID: 60998
Accepted Date and Publication Date:
September 2007Published
Date Deposited: 29 Sep 2008
Last Modified: 31 Mar 2016 12:43

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