The purpose of this study is to investigate whether exposure to hypertensive disorders of pregnancy and/or a preterm birth results in alterations in the cardiovascular system during infancy.
While the incidence of cardiovascular disease has reduced dramatically, coinciding with favourable changes in risk factors, cardiovascular disease remains the single largest cause of mortality and premature mortality in the United Kingdom. Identification of novel biological pathways that underlie disease susceptibility raises the potential for new early primary prevention strategies to complement classical management. There is particular interest in the role of early environment in 'programming' risk of cardiovascular disease in later life and growing evidence that various early life exposures impact cardiovascular health in the longer term. The investigators have therefore designed the EPOCH study to investigate whether those individuals born to hypertensive pregnancies and/or to a preterm birth demonstrate differences in the cardiovascular phenotype at birth, or whether they develop any differences over the first three months of life and whether this varies with other perinatal factors. This study also allows investigation of the short term impact of perinatal interventions used in this cohort. Comprehensive multi-modality non-invasive imaging measures of cardiovascular structure and function allow precise quantification of cardiovascular phenotype in this population.
Study Type
OBSERVATIONAL
Enrollment
300
Cardiovascular Clinical Research Facility, Dept of Cardiovascular Medicine, University of Oxford
Oxford, Oxfordshire, United Kingdom
RECRUITINGSystolic Cardiac Function
Cardiac Function will be assessed by ECHO at birth and 3 months
Time frame: Birth and 3 months
Micro-vascular Structure
Micro-vascular Structure will be assessed using Side Stream Dark Field (SDF) imaging device at birth and 3 months (as capillary density at baseline)
Time frame: Birth and 3 months
Pulse wave velocity and pulse-wave analysis
Time frame: Birth and 3 months
Cardiac Structure
Cardiac structure will be assessed by echocardiography at in utero, at birth and 3 months (as left and right ventricular mass)
Time frame: Birth and 3 months
Cardiac diastolic function
Cardiac Function will be assessed by ECHO at birth and 3 months
Time frame: Birth and 3 months
Blood pressure
Time frame: Birth and 3 months
Heart rate variability
Heart rate variability will be assessed by a 5 minute electrocardiogram
Time frame: Birth and 3 months
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