PATTERNS OF PRENATAL GROWTH AMONG INFANTS WITH CARDIOVASCULAR MALFORMATIONS - POSSIBLE FETAL HEMODYNAMIC-EFFECTS

This study characterized fetal growth differences among control infant s (n = 276) and infants with d-transposition of the great arteries (TG A) (n = 69), tetralogy of Fallot (n = 66), hypoplastic left heart synd rome (n = 51), and coarctation of the aorta (n = 65), thus permitting assessment of competing theories about the relation between these card iovascular malformations and fetal growth disturbance, Subjects were l iveborn singletons without genetic or extra-cardiovascular structural abnormalities sampled from the Baltimore-Washington Infant Study. Mult ivariate analysis of covariance was performed: birth weight, birth len gth, newborn head circumference, and two nonlinear functions of these measures were regressed jointly on a diagnostic class variable and cov ariates. Differences in the vectors of dependent variable means across diagnostic groups were striking (p < 0.0001), Infants with TGA had no rmal birth weight, but lesser head volume relative to birth weight, In fants with tetralogy of Fallot were smaller in all measured dimensions , but they were shaped normally, Infants with hypoplastic left heart s yndrome were smaller in all measured dimensions, and head volume was d isproportionately small relative to birth weight, Infants with coarcta tion of the aorta had lower birth weight, shorter birth length, and gr eater head volume relative to birth weight. These findings suggest tha t fetal circulatory abnormalities may predict abnormal patterns of fet al growth.