Pressão arterial e tamanho renal em recém-nascidos no termo com restrição de crescimento intra-uterino
Palavras-chave:
Pressão arterial, Retardo do crescimento fetal, Recém-nascido, Rim, ReninaResumo
CONTEXTO E OBJETIVO: O baixo peso ao nascimento está associado à pressão arterial mais elevada na criança e no adulto. O objetivo foi avaliar a infl uência do retardo do crescimento intra-uterino (RCIU) na pressão arterial sistólica de recém-nascidos (PAS). TIPO DE ESTUDO E LOCAL: Estudo prospectivo, realizado no berçário anexo à maternidade, Instituto da Criança, Hospital das Clínicas da Universidade de São Paulo. MÉTODOS: 35 recém-nascidos (RN) com RCIU e 35 RN sem RCIU foram avaliados em um estudo prospectivo. Os critérios de inclusão foram: recém-nascidos no termo, saudáveis, sem malformações e índice de Apgar de quinto minuto > 6. Parâmetros antropométricos (peso ao nascimento, relação comprimento renal/peso ao nascimento), dimensões renais (pela ultra-sonografi a), dosagem da atividade da renina plasmática (ARP) e a evolução da PAS foram analisadas durante o primeiro mês de vida (no 1o , 3o , 7o e 30o dias de vida). RESULTADOS: A evolução da PAS, relação peso renal/peso ao nascimento e ARP não apresentaram diferença entre os dois grupos. Em recém-nascidos com CIUR, a correlação entre PAS e PN (r = 0,387 p = 0,026) e IMC (r = 0,412 p = 0,017) foi positiva no 7o dia de vida. No 30o dia de vida, a correlação com PN (r = 0,440 p = 0,01) e comprimento ao nascimento (r = 0,386 p = 0,026) também foi positiva. Houve correlação negativa entre a PAS do 7o dia e a relação peso do rim/peso ao nascimento (r = - 0,420 p = 0,014), porém, esta correlação não persistiu ao longo do primeiro mês de vida. CONCLUSÕES: RCIU parece não infl uenciar a PAS, a atividade de renina plasmática ou o peso renal em recém-nascidos no termo durante o primeiro mês de vida.
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