Intrauterine Growth Restriction research at the Clínic

Research is carried out at the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) in the group:

• Foetal and Perinatal Medicine in Area 3, Liver, digestive system and metabolism.

Numerous sources of European and national funding have been received; all of it linked to projects of great impact in the clinical management of this disease.

Currently, the two main lines of research in this field are:

• Pathophysiology of IUGR to find tools to improve the diagnosis and subsequent prediction of small foetuses at high risk of adverse perinatal outcome, as well as to try to characterise the phenotypic variability of small foetuses.
• The second line is more focused on evaluating the neurological and cardiovascular impact of placental insufficiency, both in the prenatal period and in childhood and adult life. For example, basic experimentation is being carried out in an animal model for placental insufficiency in pregnant rabbits. This model has made it possible to demonstrate how neurological injury correlates with the onset time of placental insufficiency and the severity of the hypoxic injury. In addition, a good correlation between foetal haemodynamic changes and astrocyte injury has been demonstrated in a collaborative project of neuroscience professionals, entitled “Molecular mechanisms of excitotoxic oligodendrocyte cell death”.

At a more clinical level, to assess the neurological and cardiovascular impact of IUGR, the group has focused its research mainly on neurological injury and cardiac remodelling, secondary to placental insufficiency.

Neurological injury research has been carried out in projects funded by the CEREBRA Foundation (2008-2011) “British Foundation for Brain Injured Children” and the Thrasher Foundation (2008-2011) “Thrasher Research Foundation for Paediatric Medical research”.

It has been shown in vivo that there are significant differences in the foetal brain in haemodynamic adaptation to chronic hypoxia due to placental insufficiency. The group has also shown that even in the early stages of placental insufficiency there is suboptimal neurological development at 2 years of age.

Within the framework of a European Commission TOK (transfer of knowledge) project, the group is developing the automatic segmentation of volumes obtained by 3D ultrasound for the automatic calculation of areas and regional perfusion.

The team has published more than 160 papers in international journals in the last 10 years.

In addition, the group is currently collaborating on a research project with La Caixa Obra Social, to improve understanding and identification of foetuses with IUGR and the repercussions of chronic hypoxia on abnormal neurological development and worse cardiovascular function, through experimental and clinical validation of new biomarkers. In this area, the group has published 60 articles in indexed journals.