IUGR leads to major neonatal morbidity and mortality. Moreover, recent birth registry studies have suggested that women bearing IUGR babies may have an elevated risk of cardiovascular disease. We propose a cohort study to test whether exposed women, with a previous IUGR baby, versus unexposed women, with a pregnancy not complicated by IUGR, will have elevations in markers of cardiovascular risk. Exposure will be defined among a geographically defined cohort as having had &singleton baby in the <5 %tile of weight for gestational age, in the absence of pre-pregnancy diabetes., hypertension, renal disease, or hypertension in pregnancy;controls will have had a singleton in the >20%tile. Five to nine years postpartum, women will be assessed for multiple markers of cardiovascular risk, including blood pressure, lipids, adiposity, glucose and insulin, homocysteine and folate, markers of inflammation, markers of endothelial function, markers of angiogenesis, and markers of vascular function. Data analysis will consist of ANOVA and ANCOVA analyses comparing the outcomes of cardiovascular markers among exposed and unexposed women. Our success in accomplishing these studies derives from a long track record of success of completing women's health cohort studies, and specifically, a similar study in preeclamptic women. The importance of this work is the potential identification of a group at high risk for later cardiovascular disease. The presence of risk markers at an early age, specifically an age wherein markers of cardiovascular risk are typically not measured, may allow for implementation of early preventative interventions.
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