THE EFFECT OF INTRAUTERINE GROWTH-RETARDATION ON THE DEVELOPMENT OF RENAL NEPHRONS

被引:441
作者
HINCHLIFFE, SA [1 ]
LYNCH, MRJ [1 ]
SARGENT, PH [1 ]
HOWARD, CV [1 ]
VANVELZEN, D [1 ]
机构
[1] UNIV LIVERPOOL,ROYAL LIVERPOOL CHILDRENS HOSP,DEPT FETAL & INFANT PATHOL,ALDER HEY,EATON RD,LIVERPOOL L12 2AP,ENGLAND
来源
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY | 1992年 / 99卷 / 04期
关键词
D O I
10.1111/j.1471-0528.1992.tb13726.x
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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 > 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 < 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.
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页码:296 / 301
页数:6
相关论文
共 29 条
[1]   A PRACTICAL CLASSIFICATION OF NEWBORN INFANTS BY WEIGHT AND GESTATIONAL AGE [J].
BATTAGLI.FC ;
LUBCHENC.LO .
JOURNAL OF PEDIATRICS, 1967, 71 (02) :159-+
[2]  
BLAND M, 1987, INTRO MED STATISTICS
[3]   THE TOTAL NUMBER OF NEURONS IN THE HUMAN NEOCORTEX UNBIASEDLY ESTIMATED USING OPTICAL DISECTORS [J].
BRAENDGAARD, H ;
EVANS, SM ;
HOWARD, CV ;
GUNDERSEN, HJG .
JOURNAL OF MICROSCOPY-OXFORD, 1990, 157 :285-304
[4]  
CAMPBELL S, 1976, FETAL PHYSL MED, P271
[5]   INTRAUTERINE GROWTH-RETARDATION [J].
CHISWICK, ML .
BRITISH MEDICAL JOURNAL, 1985, 291 (6499) :845-848
[6]  
Cochran W. G., 2007, SAMPLING TECHNIQUES
[7]   FETAL KIDNEY VOLUME AND URINE PRODUCTION IN CASES OF FETAL GROWTH-RETARDATION [J].
DEUTINGER, J ;
BARTL, W ;
PFERSMANN, C ;
NEUMARK, J ;
BERNASCHEK, G .
JOURNAL OF PERINATAL MEDICINE, 1987, 15 (03) :307-315
[8]  
GRUENWALD P, 1960, AM J CLIN PATHOL, V34, P247
[9]   NOTES ON ESTIMATION OF NUMERICAL DENSITY OF ARBITRARY PROFILES - EDGE EFFECT [J].
GUNDERSEN, HJG .
JOURNAL OF MICROSCOPY-OXFORD, 1977, 111 (NOV) :219-223
[10]   STEREOLOGY OF ARBITRARY PARTICLES - A REVIEW OF UNBIASED NUMBER AND SIZE ESTIMATORS AND THE PRESENTATION OF SOME NEW ONES, IN MEMORY OF THOMPSON,WILLIAM,R. [J].
GUNDERSEN, HJG .
JOURNAL OF MICROSCOPY, 1986, 143 :3-45