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We aimed to evaluate the differential effect of ART and SGA on fetal cardiac remodeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective cohort study of term singleton pregnancies seen at our department between April 2011 and September 2013. The cohort was divided according to fetal growth and mode of conception into the following four groups: 102 appropriate\u2010for\u2010gestational\u2010age (AGA) fetuses conceived spontaneously (controls), 72 AGA fetuses conceived by ART (ART\u2010AGA), 31 SGA fetuses conceived by ART (ART\u2010SGA) and 28 SGA fetuses conceived naturally (Spont\u2010SGA). SGA was defined as birth weight &lt;\u200910<jats:sup>th<\/jats:sup> centile. Fetal echocardiography was performed at 28\u201332 weeks to assess cardiac dimensions, geometry and function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ART fetuses had dilated atria (mean left atrium\u2010to\u2010heart area ratio: controls, 15\u2009\u00b1\u20092.7%; ART\u2010AGA, 18\u2009\u00b1\u20094.1%; Spont\u2010SGA, 14\u2009\u00b1\u20093.7%) and more globular ventricles (left ventricular sphericity index: controls, 1.77\u2009\u00b1\u20090.2; ART\u2010AGA, 1.68\u2009\u00b1\u20090.2; Spont\u2010SGA, 1.72\u2009\u00b1\u20090.2), with normally sized hearts. In contrast, SGA fetuses had enlarged hearts (cardiothoracic ratio: controls, 24\u2009\u00b1\u20093%; ART\u2010AGA, 24\u2009\u00b1\u20094%; Spont\u2010SGA, 29\u2009\u00b1\u20096%), preserved atrial size, more globular and concentric hypertrophic ventricles (left ventricle  relative wall thickness: controls, 0.48\u2009\u00b1\u20090.17; ART\u2010AGA, 0.54\u2009\u00b1\u20090.13; Spont\u2010SGA, 0.63\u2009\u00b1\u20090.23). Both ART and SGA fetuses had decreased longitudinal motion (tricuspid annular ring displacement: controls, 6.5\u2009\u00b1\u20090.8 mm; ART\u2010AGA, 5.5\u2009\u00b1\u20090.7 mm; Spont\u2010SGA, 5.9\u2009\u00b1\u20090.6 mm) and impaired relaxation (left isovolumetric relaxation time: controls, 47.0\u2009\u00b1\u20097.3 ms; ART\u2010AGA, 50.0\u2009\u00b1\u20097.9 ms; Spont\u2010SGA, 49.5\u2009\u00b1\u20099.3 ms). ART\u2010SGA fetuses presented a combination of features from both ART and SGA groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SGA and conception with ART were associated with distinct patterns of fetal cardiac remodeling, supporting the concept that they are independent causes of cardiac programming. Copyright \u00a9 2016 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.16217","type":"journal-article","created":{"date-parts":[[2016,7,15]],"date-time":"2016-07-15T15:20:53Z","timestamp":1468596053000},"page":"63-70","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Differential effect of assisted reproductive technology and small\u2010for\u2010gestational age on fetal cardiac remodeling"],"prefix":"10.1002","volume":"50","author":[{"given":"B.","family":"Valenzuela\u2010Alcaraz","sequence":"first","affiliation":[{"name":"BCNatal\u00a0\u2013\u00a0Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona 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Investigaci\u00f3n en Neurodesarrollo  Instituto de Neurobiolog\u00eda, Universidad Nacional Aut\u00f3noma de M\u00e9xico (UNAM) Campus Juriquilla Quer\u00e9taro Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Bijnens","sequence":"additional","affiliation":[{"name":"ICREA\u00a0\u2013\u00a0Universitat Pompeu Fabra  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Garc\u00eda\u2010Otero","sequence":"additional","affiliation":[{"name":"BCNatal\u00a0\u2013\u00a0Barcelona Center for Maternal\u2010Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de Deu), Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Sitges","sequence":"additional","affiliation":[{"name":"Department of Cardiology, 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