{"title":"Factors Predicting Fetal Growth Restriction and Fetal Cardiac Remodeling.","authors":"XiaoLe Chen, Lili Xiao, Daozhu Wu, Saida Pan","doi":"10.2147/IJGM.S483150","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate factors influencing fetal growth restriction (FGR) occurrence and assess the clinical significance of fetal cardiac parameters in FGR prediction.</p><p><strong>Methods: </strong>Pregnant women with clinically suspected FGR (n=179) and uncomplicated pregnancies (n=53) were included. All had undergone routine obstetric ultrasonography and fetal echocardiography. Umbilical artery flow (UAF) and fetal cardiac parameters (left atrial transverse diameter (LAd), right atrial transverse diameter (RAd), left ventricular transverse diameter (LVd), right ventricular transverse diameter (RVd), foramen ovale width, atrial septum diameter, interventricular septal thickness, left ventricular posterior wall thickness, right ventricular free wall thickness, aortic diameter, pulmonary artery diameter, mitral E velocity, mitral A velocity, tricuspid E velocity, tricuspid A velocity, aortic valve peak flow velocity, and pulmonary valve peak flow velocity) were detected. Follow up was conducted until birth, various fetal clinical parameters were collected: maternal body mass index (BMI), hypertensive disorders complicating pregnancy (HDCP), abnormal umbilical artery flow, placental or umbilical cord anomalies, low amniotic fluid volume, preterm birth, emergency cesarean delivery, maternal height, maternal age, gestational diabetes mellitus (GDM), hypothyroidism, assisted reproductive technology (ART), parity, and neonatal gender. Participants were categorized into confirmed FGR (n=119) and control (n=113) groups based on neonatal birth weight.</p><p><strong>Results: </strong>Significant differences were observed between groups in maternal BMI, HDCP, abnormal UAF, placental or umbilical cord anomalies, low amniotic fluid volume, preterm birth, and emergency cesarean delivery. FGR was positively related to abnormal UAF, placental or umbilical cord anomalies, preterm birth and emergency cesarean delivery and negatively to maternal BMI (r=-0.276). Compared to the control group, the FGR group exhibited significantly larger RAd, RVd, RA/LA, and RV/LV.</p><p><strong>Conclusion: </strong>Fetal growth-restricted fetuses have enlarged right heart structures. Fetal cardiac examinations are valuable for early FGR diagnosis, potentially improving neonatal body weight and reducing adverse pregnancy outcomes.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"17 ","pages":"5423-5432"},"PeriodicalIF":2.1000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585976/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of General Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJGM.S483150","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This study aimed to investigate factors influencing fetal growth restriction (FGR) occurrence and assess the clinical significance of fetal cardiac parameters in FGR prediction.
Methods: Pregnant women with clinically suspected FGR (n=179) and uncomplicated pregnancies (n=53) were included. All had undergone routine obstetric ultrasonography and fetal echocardiography. Umbilical artery flow (UAF) and fetal cardiac parameters (left atrial transverse diameter (LAd), right atrial transverse diameter (RAd), left ventricular transverse diameter (LVd), right ventricular transverse diameter (RVd), foramen ovale width, atrial septum diameter, interventricular septal thickness, left ventricular posterior wall thickness, right ventricular free wall thickness, aortic diameter, pulmonary artery diameter, mitral E velocity, mitral A velocity, tricuspid E velocity, tricuspid A velocity, aortic valve peak flow velocity, and pulmonary valve peak flow velocity) were detected. Follow up was conducted until birth, various fetal clinical parameters were collected: maternal body mass index (BMI), hypertensive disorders complicating pregnancy (HDCP), abnormal umbilical artery flow, placental or umbilical cord anomalies, low amniotic fluid volume, preterm birth, emergency cesarean delivery, maternal height, maternal age, gestational diabetes mellitus (GDM), hypothyroidism, assisted reproductive technology (ART), parity, and neonatal gender. Participants were categorized into confirmed FGR (n=119) and control (n=113) groups based on neonatal birth weight.
Results: Significant differences were observed between groups in maternal BMI, HDCP, abnormal UAF, placental or umbilical cord anomalies, low amniotic fluid volume, preterm birth, and emergency cesarean delivery. FGR was positively related to abnormal UAF, placental or umbilical cord anomalies, preterm birth and emergency cesarean delivery and negatively to maternal BMI (r=-0.276). Compared to the control group, the FGR group exhibited significantly larger RAd, RVd, RA/LA, and RV/LV.
Conclusion: Fetal growth-restricted fetuses have enlarged right heart structures. Fetal cardiac examinations are valuable for early FGR diagnosis, potentially improving neonatal body weight and reducing adverse pregnancy outcomes.
目的本研究旨在探讨影响胎儿生长受限(FGR)发生的因素,并评估胎儿心脏参数在预测FGR中的临床意义:方法:纳入临床疑似FGR孕妇(179人)和无并发症孕妇(53人)。所有孕妇均接受了常规产科超声检查和胎儿超声心动图检查。还检测了左心室后壁厚度、右心室游离壁厚度、主动脉直径、肺动脉直径、二尖瓣 E 峰流速、二尖瓣 A 峰流速、三尖瓣 E 峰流速、三尖瓣 A 峰流速、主动脉瓣峰流速和肺动脉瓣峰流速。随访至胎儿出生,收集各种胎儿临床参数:产妇体重指数(BMI)、妊娠并发高血压疾病(HDCP)、脐动脉血流异常、胎盘或脐带异常、羊水量过少、早产、紧急剖宫产、产妇身高、产妇年龄、妊娠糖尿病(GDM)、甲状腺功能减退症、辅助生殖技术(ART)、胎次和新生儿性别。根据新生儿出生体重将参与者分为确诊 FGR 组(119 人)和对照组(113 人):结果:在产妇体重指数、HDCP、UAF异常、胎盘或脐带异常、羊水量过少、早产和紧急剖宫产方面,观察到组间存在显著差异。FGR与UAF异常、胎盘或脐带异常、早产和紧急剖宫产呈正相关,与产妇体重指数呈负相关(r=-0.276)。与对照组相比,FGR组的RAd、RVd、RA/LA和RV/LV明显增大:结论:胎儿生长受限会导致右心结构增大。结论:胎儿生长受限会导致右心结构增大,胎儿心脏检查对早期诊断 FGR 很有价值,有可能改善新生儿体重并减少不良妊娠结局。
期刊介绍:
The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas.
A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal.
As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.