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Relationship between prenatal and postnatal conditions and accelerated postnatal growth. Impact on the rigidity of the arterial wall and obesity in childhood

Published online by Cambridge University Press:  29 November 2018

A. I. Mora-Urda Open the ORCID record for A. I. Mora-Urda [Opens in a new window] ,
P. Acevedo  and
M. P. Montero López
A. I. Mora-Urda*
Affiliation:
Department of Biology, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain
P. Acevedo
Affiliation:
Department of Biology, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain
M. P. Montero López
Affiliation:
Department of Biology, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain
*
*Address for correspondence: Dr A. I. Mora-Urda, Department of Biology, Faculty of Sciences, Autonomous University of Madrid, Madrid, Spain. E-mail: ana.mora@uam.es
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Abstract

Restricted growth in utero and accelerated postnatal growth (APG) in the postnatal period have been associated with the development of overweight, obesity and an increased cardiovascular risk in childhood. The objectives of this study were to evaluate the influence of prenatal and perinatal conditions on APG and to evaluate the influence of this APG on different cardiovascular risk factors such as body mass index (BMI), body fat mass index (FMI), blood pressure (BP) and arterial wall stiffness [carotid to femoral pulse wave velocity (cf-PWV)]. All measurements were performed in 355 children (185 boys and 170 girls; 8–11 years). Data on mother weight before and during pregnancy, gestational age (weeks), birth weight (g) and breastfeeding of children were obtained through interviews with families. Children who presented APG were born of mothers with lower BMIs before pregnancy and who gained less weight during the second trimester of pregnancy. They also have a lower gestational age and birth weight, a shorter duration of breastfeeding and a longer duration of artificial feeding (AF). Later in childhood, they had higher values of cf-PWV, BMI, FMI and higher prevalence of hypertension. Low maternal gestational weight gain, inadequate fetal development (low birth weight, shorter gestational age) and reduced breastfeeding duration favor APG. Infants with such APG had higher values of cf-PWV, BP, BMI and FMI later in childhood, along with a higher risk of hypertension and obesity. The interaction between APG and a longer duration of AF had a negative effect on cf-PWV (arterial stiffness) and FMI.

Keywords

accelerated postnatal growtharterial stiffness in childhoodbreastfeedinghypertensionobesityprenatal conditions
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 10 , Issue 4 , August 2019 , pp. 436 - 446
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019 

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References

1. Dennison, BA, Edmunds, LS, Stratton, HH, Pruzek, RM. Rapid infant weight gain predicts childhood overweight. Obesity. 2006; 14, 491–499.CrossRefGoogle ScholarPubMed
2. Holzhauer, S, Hokken Koelega, ACS, Ridder, M, et al. Effect of birth weight and postnatal weight gain on body composition in early infancy: The Generation R Study. Early Hum Dev. 2009; 85, 285–290.CrossRefGoogle ScholarPubMed
3. Monteiro, POA, Victora, CG. Rapid growth in infancy and childhood and obesity in later life – a systematic review. Obes Rev. 2005; 6, 143–154.CrossRefGoogle ScholarPubMed
4. Fabricius-Bjerre, S, Jensen, RB, Færch, K, et al. Impact of birth weight and early infant weight gain on insulin resistance and associated cardiovascular risk factors in adolescence. PLoS One. 2011; 6, e20595.CrossRefGoogle ScholarPubMed
5. Rolland-Cachera, MF. Rate of growth in early life: a predictor of later health? In: Early Nutrition and its Later Consequences: New Opportunities, 2005; pp. 35–39. Springer-Verlag: Berlin/Heidelberg.CrossRefGoogle Scholar
6. Chrestani, MA, Santos, IS, Horta, BL, Dumith, SC, de Oliveira Dode, MAS. Associated factors for accelerated growth in childhood: a systematic review. Matern Child Health J. 2013; 17, 512–519.CrossRefGoogle ScholarPubMed
7. Ong, KK. Size at birth and early childhood growth in relation to maternal smoking, parity and infant breast-feeding: longitudinal birth cohort study and analysis. Pediatric Res. 2002; 52, 863–867.CrossRefGoogle ScholarPubMed
8. Costa-Silva, JH, Simões-Alves, AC, Fernandes, MP. Developmental origins of cardiometabolic diseases: role of the maternal diet. Front Physiol. 2016; 7, 504.CrossRefGoogle ScholarPubMed
9. Hediger, ML, Overpeck, MD, Maurer, KR, et al. Growth of infants and young children born small or large for gestational age: findings from the Third National Health and Nutrition Examination Survey. Arch Pediatr Adolesc Med. 1998; 152, 1225–1231.CrossRefGoogle ScholarPubMed
10. Wells, JCK. The programming effects of early growth. Early Hum Dev. 2007; 83, 743–748.CrossRefGoogle ScholarPubMed
11. Hales, C, Barker, D. Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Int J Epidemiol. 2013; 42, 1215–1222.CrossRefGoogle ScholarPubMed
12. Luyckx, VA, Bertram, JF, Brenner, BM, et al. Effect of fetal and child health on kidney development and long-term risk of hypertension and kidney disease. Lancet. 2013; 382, 273–283.CrossRefGoogle ScholarPubMed
13. Smith, CJ, Ryckman, KK, Barnabei, VM, et al. The impact of birth weight on cardiovascular disease risk in the Women’s Health Initiative. Nutr Metab Cardiovasc Dis. 2016; 26, 239–245.CrossRefGoogle ScholarPubMed
14. Zhou, J, Dang, S, Zeng, L, et al. Rapid infancy weight gain and 7- to 9-year childhood obesity risk: a prospective cohort study in rural western China. Medicine. 2016; 95, e3425.CrossRefGoogle ScholarPubMed
15. Ong, K, Loos, R. Rapid infancy weight gain and subsequent obesity: systematic reviews and hopeful suggestions. Acta Paediatr. 2006; 95, 904–908.CrossRefGoogle ScholarPubMed
16. Griffiths, LJ, Smeeth, L, Hawkins, SS, Cole, TJ, Dezateux, C. Effects of infant feeding practice on weight gain from birth to 3 years. Arch Dis Child. 2009; 94, 577–582.CrossRefGoogle ScholarPubMed
17. Singhal, A, Lucas, A. Early origins of cardiovascular disease: is there a unifying hypothesis? Lancet. 2004; 363, 1642–1645.CrossRefGoogle Scholar
18. Victora, CG, Barros, FC, Horta, BL, Martorell, R. Short-term benefits of catch-up growth for small-for-gestational-age infants. Int J Epidemiol. 2001; 30, 1325–1330.CrossRefGoogle ScholarPubMed
19. Gardiner, HM. Early environmental influences on vascular development. Early Hum Dev. 2007; 83, 819–823.CrossRefGoogle ScholarPubMed
20. Giles, LC, Whitrow, MJ, Davies, MJ, et al. Growth trajectories in early childhood, their relationship with antenatal and postnatal factors, and development of obesity by age 9 years: results from an Australian birth cohort study. Int J Obes. 2015; 39, 1049–1056.CrossRefGoogle ScholarPubMed
21. Gillman, MW. Early infancy – a critical period for development of obesity. J Dev Orig Health Dis. 2010; 1, 292–299.CrossRefGoogle ScholarPubMed
22. Horta, BL, Barros, FC, Victora, CG, Cole, TJ. Early and late growth and blood pressure in adolescence. J Epidemiol Community Health. 2003; 57, 226–230.CrossRefGoogle ScholarPubMed
23. Lucas, A. Growth and later health: a general perspective. In: Importance of Growth for Health and Development (vol. 65), 2010; pp. 1–11. Karger: Basel.Google Scholar
24. Nilsson, P. The early life origins of vascular ageing and cardiovascular risk: the EVA syndrome. J Hypertens. 2008; 26, 1049–1057.CrossRefGoogle ScholarPubMed
25. Slining, MM, Herring, AH, Popkin, BM, Mayer-Davis, EJ, Adair, LS. Infant BMI trajectories are associated with young adult body composition. J Dev Orig Health and Dis. 2012; 4, 56–68.CrossRefGoogle Scholar
26. Sandboge, S, Osmond, C, Kajantie, E, Eriksson, JG. Early growth and changes in blood pressure during adult life. J Dev Orig Health Dis. 2016; 7, 306–313.CrossRefGoogle ScholarPubMed
27. Wells, JCK, Hallal, PC, Wright, A, Singhal, A, Victora, CG. Fetal, infant and childhood growth: relationships with body composition in Brazilian boys aged 9 years. Int J Obes. 2005; 29, 1192–1198.CrossRefGoogle ScholarPubMed
28. Ong, KK, Ahmed, ML, Emmett, PM, Preece, MA, Dunger, DB. Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. BMJ. 2000; 967–971.CrossRefGoogle ScholarPubMed
29. Mitchell, GF. Arterial stiffness and hypertension: chicken or egg? Hypertension. 2014; 64, 210–214.CrossRefGoogle ScholarPubMed
30. Sebastiani, G, Díaz, M, Bassols, J, et al. The sequence of prenatal growth restraint and post-natal catch-up growth leads to a thicker intima-media and more pre-peritoneal and hepatic fat by age 3-6 years. Pediatr Obes. 2016; 11, 251–257.CrossRefGoogle ScholarPubMed
31. Tauzin, L, Rossi, P, Grosse, C, et al. Increased systemic blood pressure and arterial stiffness in young adults born prematurely. J Dev Orig Health and Dis. 2014; 5, 448–452.CrossRefGoogle ScholarPubMed
32. Evelein, AMV, Visseren, FLJ, van der Ent, CK, Grobbee, DE, Uiterwaal, CSPM. Excess early postnatal weight gain leads to thicker and stiffer arteries in young children. J Clin Endocrinol Metab. 2013; 98, 794–801.CrossRefGoogle ScholarPubMed
33. Arribas, SM, Hinek, A, González, MC. Elastic fibres and vascular structure in hypertension. Pharmacol Ther. 2006; 111, 771–91.CrossRefGoogle ScholarPubMed
34. Vlachopoulos, C, Xaplanteris, P, Aboyans, V, et al. The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY). Atherosclerosis. 2015; 241, 507–532.CrossRefGoogle Scholar
35. Martyn, CN, Greenwald, SE. Impaired synthesis of elastin in walls of aorta and large conduit arteries during early development as an initiating event in pathogenesis of systemic hypertension. Lancet. 1997; 350, 953–955.CrossRefGoogle Scholar
36. Martyn, CN, Greenwald, SE. A hypothesis about a mechanism for the programming of blood pressure and vascular disease in early life. Clin Exp Pharmacol Physiol. 2001; 28, 948–951.CrossRefGoogle ScholarPubMed
37. Greenwald, SE. Ageing of the conduit arteries. J Pathol. 2007; 2011, 157–172.CrossRefGoogle Scholar
38. WHO. Ethical principles for medical research involving human subjects. JAMA. 2000; 284, 3045–3046.Google Scholar
39. National Research Council. Weight Gain During Pregnancy: Reexamining the Guidelines. 2010. National Academies Press: Washington, D.C.Google Scholar
40. WHO. Indicators for Assessing Infant and Young Child Feeding Practices: Conclusions of a Consensus Meeting Held 6-8 November 2007 in Washington DC, USA, 2008. World Health Organization: Geneva.Google Scholar
41. Ng, SK, Olog, A, Spinks, AB, et al. Risk factors and obstetric complications of large for gestational age births with adjustments for community effects: results from a new cohort study. BMC Public Health. 2010; 10, 460.CrossRefGoogle ScholarPubMed
42. de Onis, M, Onyango, AW, Borghi, E, Siyam, A, Nishida, CSJ. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007; 85, 660–667.CrossRefGoogle ScholarPubMed
43. WHO. Development of a WHO growth reference for school-aged children and adolescents, 2014. World Health Organization: Geneva.Google Scholar
44. Karaolis-Danckert, N, Buyken, AE, Kulig, M, et al. How pre- and postnatal risk factors modify the effect of rapid weight gain in infancy and early childhood on subsequent fat mass development: results from the Multicenter Allergy Study 90. Am J Clin Nutr. 2008; 87, 1356–1364.CrossRefGoogle ScholarPubMed
45. Oyama, M, Nakamura, K, Tsuchiya, Y, Yamamoto, M. Unhealthy maternal lifestyle leads to rapid infant weight gain: prevention of future chronic diseases. Tohoku J Exp Med. 2009; 217, 67–72.CrossRefGoogle ScholarPubMed
46. Cole, TJ. Modeling postnatal exposures and their interactions with birth size. J Nutr. 2004; 134, 201–204.CrossRefGoogle ScholarPubMed
47. Weiner, JS, Lourie, JA. Practical Human Biology. 1981. Academic Press: London/New York.Google Scholar
48. Ahmad, N, Adam, SIM, Nawi, AM, Hassan, MR, Ghazi, HF. Abdominal obesity indicators: waist circumference or waist-to-hip ratio in malaysian adults population. Int J Prev Med. 2016; 7, 82.Google ScholarPubMed
49. Mccarthy, HD. Body fat measurements in children as predictors for the metabolic syndrome: focus on waist circumference. Proc Nutr Soc. 2006; 65, 385–392.Google ScholarPubMed
50. Brook, CG. Determination of body composition of children from skinfold measurements. Arch Dis Child. 1971; 46, 182–184.CrossRefGoogle ScholarPubMed
51. Siri, WE. Body composition from fluid spaces and density. In: Techniques for Measuring Body Composition (ed. Brozeck HA), 1961; p. 300. National Academy of Sciences: Washington.Google Scholar
52. Peltz, G, Aguirre, MT, Sanderson, M, Fadden, MK. The role of fat mass index in determining obesity. Am J Hum Biol. 2010; 22, 639–47.CrossRefGoogle ScholarPubMed
53. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114, 555–576.CrossRefGoogle Scholar
54. Laurent, S, Cockcroft, J, Van Bortel, L, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006; 27, 2588–2605.CrossRefGoogle ScholarPubMed
55. Jatoi, N, Mahmud, A, Bennett, K, Feely, J. Assessment of arterial stiffness in hypertension: comparison of oscillometric (Arteriograph), piezoelectronic (Complior) and tonometric (SphygmoCor) techniques. J Hypertens. 2009; 27, 2186–2191.CrossRefGoogle ScholarPubMed
56. Mancia, G, De Backer, G, Dominiczak, A, et al. The task force for the management of arterial hypertension of the European Society of Cardiology. Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Euro Heart J. 2007; 28, 1462–1536.Google Scholar
57. Laurent, S, Katsahian, S, Fassot, C, et al. Aortic stiffness is an independent predictor of fatal stroke in essential. Hypertension. 2003; 34, 1203–1206.Google ScholarPubMed
58. Laurent, S, Boutouyrie, P, Asmar, R, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension. 2001; 37, 1236–1241.CrossRefGoogle ScholarPubMed
59. Reusz, GS, Cseprekal, O, Temmar, M, et al. Reference values of pulse wave velocity in healthy children and teenagers. Hypertension. 2010; 56, 217–224.CrossRefGoogle ScholarPubMed
60. Silva, ABT, Capingana, DP, Magalhães, P, et al. Predictors and reference values of pulse wave velocity in Prepubertal Angolan children. J Clin Hypertens. 2016; 18, 725–732.CrossRefGoogle ScholarPubMed
61. Urbina, EM, Williams, RV, Alpert, BS, et al. Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension. 2009; 54, 919–950.CrossRefGoogle ScholarPubMed
62. Mora-Urda, AI, Molina, MCB, Mill, JG, Montero-López, P. Carotid-femoral pulse wave velocity in healthy Spanish children: reference percentile curves. J Clin Hypertens. 2017; 19, 227–234.CrossRefGoogle ScholarPubMed
63. AtCor Medical. Sphygmocor Software Operator´s Guide. Retrieved January 20, 2017, from http://atcormedical.com/.Google Scholar
64. Van Bortel, LM, Laurent, S, Boutouyrie, P, et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens. 2012; 30, 445–448.CrossRefGoogle ScholarPubMed
65. Brisbois, TD, Farmer, AP, McCargar, LJ. Early markers of adult obesity: a review. Obes Rev. 2012; 13, 347–367.CrossRefGoogle ScholarPubMed
66. Ong, KK, Kennedy, K, Castañeda-Gutiérrez, E, et al. Postnatal growth in preterm infants and later health outcomes: a systematic review. Acta Paediatr. 2015; 104, 974–986.CrossRefGoogle ScholarPubMed
67. Mora-Urda, AI, Espinoza, A, López-Ejeda, N, et al. Indicadores de riesgo cardiovascular, patrones de lactancia y estilo de vida de la madre durante el proceso de crecimiento y desarrollo fetal e infantil. Nutricion Clinica y Dietetica Hospitalaria. 2015; 35, 91–100.Google Scholar
68. Bernis, C, López Giménez, R, Montero-López, P. Determinantes biológicos, psicológicos, y sociales de la maternidad en el siglo XXI: mitos y realidades : XVII Jornadas de Investigación Interdisciplinaria. 2009. Instituto Universitario de Estudios de la Mujer, Universidad Autónoma de Madrid: Madrid, Spain.Google Scholar
69. Alonso, V, Fuster, V, Luna, F. La evolución del peso al nacer en España (1981-2002) y su relación con las características de la reproducción. Antropo. 2005; 10, 51–60.Google Scholar
70. WHO. Pregnancy, Childbirth, Postpartum and Newborn Care, 2016. World Health Organization: Geneva.Google Scholar
71. Barker, DJP, Gluckman, PD, Godfrey, KM, et al. Fetal nutrition and cardiovascular disease in adult life. Lancet. 1993; 341, 938–941.CrossRefGoogle ScholarPubMed
72. Curhan, GC, Chertow, GM, Willett, WC, et al. Birth weight and adult hypertension and obesity in women. Circulation. 1996; 94, 1310–1315.CrossRefGoogle ScholarPubMed
73. Curhan, GC, Willett, WC, Rimm, EB, et al. Birth weight and adult hypertension, diabetes mellitus, and obesity in US men. Circulation. 1996; 94, 3246–3250.CrossRefGoogle ScholarPubMed
74. Jelenkovic, A, Yokoyama, Y, Sund, R, et al. Association between birthweight and later body mass index: an individual-based pooled analysis of 27 twin cohorts participating in the CODATwins project. Int J Epidemiol. 2017; 46, 1488–1498.CrossRefGoogle ScholarPubMed
75. Morley, R, Lister, G, Leeson-Payne, C, Lucas, A. Size at birth and later blood pressure. Arch Dis Child. 1994; 70, 536–537.CrossRefGoogle ScholarPubMed
76. Lurbe, E, Torro, MI, Carvajal, E, Alvarez, V, Redón, J. Birth weight impacts on wave reflections in children and adolescents. Hypertension. 2003; 41, 646–650.CrossRefGoogle ScholarPubMed
77. Oren, A. Gestational age and birth weight in relation to aortic stiffness in healthy young adults: two separate mechanisms? Am J Hypertension. 2003; 16, 76–79.CrossRefGoogle ScholarPubMed
78. Dalziel, SR, Parag, V, Rodgers, A, Harding, JE. Cardiovascular risk factors at age 30 following pre-term birth. Int J Epidemiol. 2007; 36, 907–915.CrossRefGoogle ScholarPubMed
79. Franko, DL, Blais, MA, Becker, AE, et al. Pregnancy complications and neonatal outcomes in women with eating disorders. Am J Psychiatry. 2001; 158, 1461–1466.CrossRefGoogle ScholarPubMed
80. Park, RJ, Senior, R, Stein, A. The offspring of mothers with eating disorders. Eur Child Adolesc Psychiatry. 2003; 12, 1–1.CrossRefGoogle ScholarPubMed
81. Montero, MP. La alimentación del recién nacido: condiciones culturales y sociales. In Determinantes biológicos, psicológicos y sociales de la maternidad en el siglo XXI (eds. Bernis C, López R, Montero MP), 2009; pp. 125–147. Instituto Universitario de Estudios de la Mujer, Universidad Autónoma de Madrid: Madrid, Spain.Google Scholar
82. WHO. The optimal duration of exclusive breastfeeding report of an expert consultation. 2001. WHO: Geneva, Switzerland.Google Scholar
83. Fewtrell, M. The long-term benefits of having been breast-fed. Curr Paediatr. 2004; 14, 97–103.CrossRefGoogle Scholar
84. Linhares, RS, Petrucci Gigante, D, Lopes, FC, Fernandes de Barros, B, Horta, L. Carotid intima-media thickness at age 30, birth weight, accelerated growth during infancy and breastfeeding: a birth cohort study in southern Brazil – asset. PLoS One. 2015; 1, 1–9.Google Scholar
85. Salvi, P, Revera, M, Joly, L, et al. Role of birth weight and postnatal growth on pulse wave velocity in teenagers. J Adolescent Health. 2012; 51, 373–379.CrossRefGoogle ScholarPubMed
86. Oken, E, Gillman, MW. Fetal origins of obesity. Obes Res. 2003; 11, 496–506.CrossRefGoogle ScholarPubMed
87. Ohmi, H, Kato, C, Meadows, M, et al. Early infantile growth and cardiovascular risks in adolescent Japanese women. J Rural Med. 2013; 8, 176–180.CrossRefGoogle ScholarPubMed
88. Michaelsen, KF. Are there negative effects of an excessive protein intake? Pediatrics. 2000; 106, 1293–1294.Google ScholarPubMed
89. Rolland-Cachera, MF, Deheeger, M, Akrout, M, Bellisle, F. Influence of macronutrients on adiposity development: a follow up study of nutrition and growth from 10 months to 8 years of age. Int J Obes Relat Metab Disord. 1995; 19, 573–578.Google ScholarPubMed
90. Butt, RP, Laurent, GJ, Bishop, JE. Collagen production and replication by cardiac fibroblasts is enhanced in response to diverse classes of growth factors. Eur J Cell Biol. 1995; 68, 330–335.Google ScholarPubMed
91. Sproul, EP, Argraves, WS. A cytokine axis regulates elastin formation and degradation. Matrix Biol. 2013; 32, 86–94.CrossRefGoogle ScholarPubMed
92. Westenberg, JJM, Scholte, AJHA, Vaskova, Z, et al. Age-related and regional changes of aortic stiffness in the Marfan syndrome: assessment with velocity-encoded MRI. J Magn Reson Imaging. 2011; 34, 526–531.CrossRefGoogle ScholarPubMed
93. Bhatt, AB, Buck, JS, Zuflacht, JP, et al. Distinct effects of losartan and atenolol on vascular stiffness in Marfan syndrome. Vasc Med. 2015; 20, 317–325.CrossRefGoogle ScholarPubMed
94. Grillo, A, Pini, A, Marelli, S, et al. Marfan syndrome: assessment of aortic dissection risk by analysis of aortic viscoelastic properties. J Hypertens. 2015; 33, 67.CrossRefGoogle Scholar
95. Paisley, AN, Banerjee, M, Rezai, M, et al. Changes in arterial stiffness but not carotid intimal thickness in acromegaly. J Clin Endocrinol Metab. 2011; 96, 1486–1492.CrossRefGoogle Scholar
96. Cansu, GB, Yılmaz, N, Yanıkoğlu, A, et al. Assessment of diastolic dysfunction, arterial stiffness, and carotid intima-media thickness in patients with acromegaly. Endocr Pract. 2017; 23, 536–545.CrossRefGoogle ScholarPubMed
97. Romero Gutiérrez, G, Urbina Ortiz, FJ, de Leon, A, Amador, N. Morbilidada materno-fetal en embarazadas obesas. Ginecol Obstet Mex. 2006; 74, 483–487.Google Scholar
98. Salazar de Dugarte, G, González de Chirivella, X, Faneite Antique, P. Incidencia y factores de riesgo de macrosomía fetal. Rev Obs Ginecol Venez. 2004; 64, 15–21.Google Scholar
99. Palinski, W, Napoli, C. The fetal origins of atherosclerosis: maternal hypercholesterolemia, and cholesterol-lowering or antioxidant treatment during pregnancy influence in utero programming and postnatal susceptibility to atherogenesis. FASEB J. 2002; 16, 1348–1360.CrossRefGoogle ScholarPubMed