ORIGINAL ARTICLE

Early physiological development of infants with intrauterine growth retardation

J A Jackson¹, M P Wailoo², J R Thompson³ and S A Petersen⁴

¹ Department of Child Health, University of Leicester and University of Warwick, UK
² Department of Child Health, University of Leicester
³ Department of Ophthalmology, University of Leicester
⁴ Department of Medical Education, University of Leicester

Correspondence to:
Correspondence to:
M P Wailoo
Department of Child Health, University of Leicester, PO Box 65, Leicester LE1 7LX, UK; mw33{at}le.ac.uk

Objectives: To assess the patterns of early postnatal physiological adaptation and maturation in intrauterine growth retarded (IUGR) infants by measuring changes in sleeping deep body temperature, heart rate, and concentrations of urinary cortisol.

Setting: At home.

Patients: Sixty five IUGR babies and 127 controls matched for sex, social class, and levels of parental smoking.

Results: Night time sleeping deep body temperature, heart rate, and cortisol excretion fell with age, eventually establishing an adult type diurnal rhythm of physiological function. Minimum overnight temperature showed a linear decline with age (p < 0.001), but the IUGR infants and the controls had significant differences in intercept (p = 0.007) and slope (p = 0.02). The estimated rate of decline per week was 0.020°C for IUGR infants and 0.031°C for controls. Maximum temperature did not show similar changes. IUGR infants had a mean (SE) age adjusted minimum overnight heart rate that was 4.2 (1.5) beats/min (p = 0.005) higher than controls. Overnight cortisol/creatinine ratios declined with age at a rate of 4.1% per week (log ratio -0.421 (0.0165), p = 0.01), but the ratio for IUGR infants was on average 42% higher (log ratio 0.35 (0.11), p = 0.002) than for controls of the same age. Morning cortisol concentrations did not show a similar pattern.

Conclusions: Postnatal physiological adaptation and maturation of IUGR infants is slower than normal and therefore they remain in a physiologically immature state for longer. The higher heart rates and greater cortisol excretion in such infants may be precursors to hypertension and cardiovascular disease seen in adults.

Keywords: intrauterine growth retardation; deep body temperature; heart rate; cortisol excretion

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This article has been cited by other articles:

• Heraghty, J L, Hilliard, T N, Henderson, A J, Fleming, P J (2008). The physiology of sleep in infants. Arch. Dis. Child. 93: 982-985 [Abstract] [Full Text]  
• Chakraborty, S., Joseph, D. V., Bankart, M. J. G., Petersen, S. A, Wailoo, M. P (2007). Fetal growth restriction: relation to growth and obesity at the age of 9 years. Arch. Dis. Child. Fetal Neonatal Ed. 92: F479-F483 [Abstract] [Full Text]  

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IUGR Revisited

Girish Gupta, et al.

Fetal Neonatal Ed. Online, 22 Apr 2004 [Full text]