Early human development最新文献

{"title":"The effects of early enteral feeding, fortification, and rapid feeding advancement in extremely low birth weight infants","authors":"Kyoung Eun Joung ,&nbsp;Michael Prendergast ,&nbsp;Olivia Marchioni ,&nbsp;Silvia Z. Testa","doi":"10.1016/j.earlhumdev.2025.106202","DOIUrl":"10.1016/j.earlhumdev.2025.106202","url":null,"abstract":"<div><h3>Background</h3><div>Preterm infants are at risk for necrotizing enterocolitis (NEC) and sepsis. Optimal strategies of preterm feeding to achieve full enteral feeding early with minimal duration of central lines without increasing the risk of NEC remain uncertain. We aimed to evaluate if new enteral feeding strategies reflecting early initiation, fortification, and more rapid advancement is beneficial without increasing the risk of NEC.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study including 122 infants born with birth weight &lt; 1000 g during Period 1 (old feeding protocol, n = 61) and Period 2 (new feeding protocol, n = 61) to compare the incidence of NEC, late-onset sepsis, the duration of central line, and the growth outcomes before and after the implementation of feeding strategies to reflect early initiation of feeding within 12 h of life, early fortification at 60 mL/kg/day, and more rapid feeding advancement up to 30 mL/kg/day.</div></div><div><h3>Result</h3><div>Median time to reach full enteral feeds was decreased from 9 to 6 days (p &lt; 0.001). The duration of central venous catheters was also improved from median 7 to 5 days (p &lt; 0.001). The incidence of NEC was not different (11.5 % in Period 1 vs. 8.2 % in Period 2, p = 0.54). 14 infants (23 %) had late-onset sepsis in Period 1 vs. 8 infants (13.1 %) in Period 2 (p = 0.16). The growth outcome was comparable between the two periods (p = 0.47).</div></div><div><h3>Conclusion</h3><div>Earlier initiation of enteral feeding and fortification, and more rapid advancement were safely introduced with significantly shorter duration of central lines without increasing the incidence of NEC.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"201 ","pages":"Article 106202"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental inflammatory response and association with the severity of neonatal hypoxic ischemic encephalopathy","authors":"Suleiman Mashat ,&nbsp;Lynn Bitar ,&nbsp;Imran N. Mir ,&nbsp;Rachel L. Leon ,&nbsp;L. Steven Brown ,&nbsp;Lina F. Chalak","doi":"10.1016/j.earlhumdev.2024.106179","DOIUrl":"10.1016/j.earlhumdev.2024.106179","url":null,"abstract":"<div><h3>Background</h3><div>Placental lesions are associated with worse neonatal outcomes, but their association with neonatal hypoxic-ischemic encephalopathy (HIE), including the full range of severity from mild to severe HIE, has not been well described.</div></div><div><h3>Objective</h3><div>To determine the association of acute and chronic placental lesions with mild versus moderate to severe HIE; secondarily, to assess the impact of multiple placental lesions on severity of HIE.</div></div><div><h3>Methods</h3><div>This retrospective study of prospectively collected data included neonates born at ≥36 weeks, with a birth weight of &gt;1800 g, diagnosed with HIE between January 2012 and November 2022. The cohort was divided into those with mild versus moderate to severe HIE, based on the modified Sarnat staging. Placental histologic diagnoses were made according to the Amsterdam Placental Workshop Group Consensus Statement. Placental pathologic lesions were classified into acute inflammation with attention to stages and grades of maternal and fetal inflammatory responses (MIR and FIR, respectively), maternal vascular malperfusion, fetal vascular malperfusion, villitis of unknown etiology, and other lesions. Chi-square and Fisher's exact test were used to compare rates of placental pathologies between mild and moderate to severe HIE groups.</div></div><div><h3>Results</h3><div>Of 394 neonates ≥36 weeks' gestation diagnosed with HIE, 172 had mild HIE and received supportive care, while 180 had moderate to severe HIE and underwent therapeutic hypothermia. 42 patients were excluded due to lack of placental pathology reports. FIR was significantly associated with moderate to severe HIE vs. mild HIE (53 % vs. 38 %, <em>P</em> &lt; 0.01). Higher grade and stage of FIR was also associated with worse severity of HIE (moderate to severe HIE showed FIR stage ≥2 in 81 % and grade 2 in 15 % vs. 34 % and 3 % in those with mild HIE, respectively). MIR was diagnosed in more placentas from the moderate to severe HIE group (58 % vs. 47 %, <em>P</em> = 0.04) with higher stage and grade MIR in patients with moderate to severe HIE (86 % with MIR stage ≥2 and 19 % with MIR grade 2). High-grade (patchy/diffuse) chronic villitis was more prevalent in the moderate to severe HIE group vs. mild HIE group (18 % vs. 8 %, <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>There is a higher prevalence of placental inflammatory lesions in neonates with moderate to severe HIE compared to those with mild HIE.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"201 ","pages":"Article 106179"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of feeding in elevated side-lying and paced bottle feeding on swallow-breathe coordination in healthy preterm infants – First results","authors":"Nicole Hübl ,&nbsp;Jasmin Hasmann ,&nbsp;Benjamin Riebold ,&nbsp;Nicole Kaufmann ,&nbsp;Rainer O. Seidl","doi":"10.1016/j.earlhumdev.2024.106184","DOIUrl":"10.1016/j.earlhumdev.2024.106184","url":null,"abstract":"<div><h3>Background</h3><div>Preterm infants face challenges in their suck-swallow-breathe coordination leading to an increased risk of aspiration. Key components of the swallowing process are present around 34 to 35 weeks postmenstrual age (PMA), but preterm infants fatigue early affecting timing, quality and efficiency in swallowing and prolonging breathing pauses. Feeding strategies need to address these specific challenges in suck-swallow-breathe coordination.</div></div><div><h3>Aim</h3><div>To objectively measure the effect of positioning and applying “paced bottle feeding” on swallowing and breathing function in preterm infants.</div></div><div><h3>Methods</h3><div>Two separate groups of each 20 preterm infants were measured during a single bottle feed at the age of 34 to 35 weeks PMA using a noninvasive measuring device combining bioimpedance, surface electromyography as well as a breathing belt. In the first study (S1) feeding in elevated side-lying was compared to elevated supine position for 2 min each. In the second study (S2) 2 min of paced bottle feeding was compared to 2 min without paced bottle feeding.</div></div><div><h3>Results</h3><div>(S1): Feeding in elevated side-lying led to significantly fewer episodes of choking and coughing, significantly shorter breathing pauses and significantly less variation in swallowing movements than in elevated supine. Pharyngeal closure was significantly greater in supine at the start of the feed. (S2): The application of paced bottle feeding significantly reduced the length of breathing pauses.</div></div><div><h3>Conclusions</h3><div>Feeding in elevated side-lying position and applying paced bottle feeding may support improved swallow-breathe coordination in healthy preterm infants at 34 to 35 weeks PMA.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"201 ","pages":"Article 106184"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive model of neurodevelopmental outcome in neonatal hypoxic ischemic encephalopathy","authors":"Amr I. El Shahed ,&nbsp;Helen M. Branson ,&nbsp;Anil Chacko ,&nbsp;Sangita Terumalay ,&nbsp;Xin Zheng ,&nbsp;Elizabeth W. Pang ,&nbsp;Diane Wilson ,&nbsp;Susan Blaser ,&nbsp;Vann Chau ,&nbsp;Steven P. Miller ,&nbsp;Hilary E. Whyte ,&nbsp;Linh G. Ly","doi":"10.1016/j.earlhumdev.2024.106189","DOIUrl":"10.1016/j.earlhumdev.2024.106189","url":null,"abstract":"<div><h3>Objectives</h3><div>To build an early, prognostic model for adverse outcome in infants with hypoxic ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH) based on brain magnetic resonance images (MRI), electrophysiological tests and clinical assessments were performed during the first 5 days of life.</div></div><div><h3>Methods</h3><div>Retrospective study of 182 neonates with HIE and managed with TH. The predominant pattern of HIE brain injury on MRI performed following cooling was scored by neuroradiologists. The electroencephalogram (EEG) background and evoked potential (EP) response, were analyzed. Area under the curve (AUC) of these tools for adverse outcome including death and/or moderate disabilities using the Bayley-III at 36 months were calculated. A stepwise model approach was used to reach the final most efficient predictive model.</div></div><div><h3>Results</h3><div>Of 182 neonates, 99 were male (54.4 %), with median gestational age of 39 weeks (IQR 38–40) and median weight of 3.3 kg (IQR 2.9–3.7). On admission, 47 (26 %), 104 (57 %) and 31(17 %) neonates presented with mild, moderate and severe encephalopathy respectively. In multivariate analysis of 129 infants who received all prognostic modalities, the predictive value of a model of EEG plus MRI, AUC = 84 %) is equivalent to models of EEG plus MRI with added EP and clinical assessment at discharge (AUC = 84 and 85 % respectively).</div></div><div><h3>Conclusion</h3><div>In the era of cooling for neonatal HIE, the combination of EEG background and MRI during the first few days of life, provide an objective and highly reliable model for prediction of death and long-term disabilities.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"201 ","pages":"Article 106189"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From movement to mind: Early fine motor skills are associated with cognitive performance at school age in very preterm infants","authors":"J.S. Meijer ,&nbsp;M.L. de Jonge ,&nbsp;S. Leenen ,&nbsp;P.E. van Beek ,&nbsp;E. de Kort ,&nbsp;B. Vugs ,&nbsp;P. Andriessen","doi":"10.1016/j.earlhumdev.2025.106197","DOIUrl":"10.1016/j.earlhumdev.2025.106197","url":null,"abstract":"<div><h3>Background</h3><div>Although preterm birth is associated with deficits in both motor and cognitive functioning, the association between early motor skills and cognitive outcomes at a later age remains underexplored.</div></div><div><h3>Aim</h3><div>To evaluate associations between motor skills at age 5.5 and cognitive functioning at age 8.</div></div><div><h3>Methods</h3><div>Single-center cohort study including children born below 30 weeks' gestation or below 1000 g, between September 1st 2010 and September 1st 2015. Three motor skills (aiming and catching, balance and manual dexterity) were assessed at age 5.5 using the Movement Assessment Battery for Children, 2nd edition (MABC-2-NL). Total intelligence quotient and its five subdomains (fluid reasoning, processing speed, verbal comprehension, visual spatial, and working memory) were assessed at age 8 using the fifth version of the Wechsler Intelligence Scale for Children (WISC-V-NL). Multiple linear regression analysis was used to investigate associations between MABC-2-NL scores and WISC-V-NL outcomes.</div></div><div><h3>Results</h3><div>In total, 327 live born children without congenital malformations were included, of whom 281 survived to 8 years. Of these, 185 (66 %) had follow-up assessments at both 5.5 and 8 years. Scores on motor and cognitive subdomains were lower compared to the normative mean. Regression analysis showed that manual dexterity was significantly associated with better scores on all subdomains of cognitive performance, except for verbal comprehension.</div></div><div><h3>Conclusion</h3><div>Our main finding is that fine motor function at age 5.5 is associated with later cognitive performance. Early assessment of motor performance may be helpful for early diagnosis and targeted intervention to support optimal cognitive development of preterm children.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"201 ","pages":"Article 106197"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motor dysfunction in preschool children exposed to zika virus during pregnancy and normocephalic at birth: Developmental Coordination Disorder and Minimal Neurological Dysfunction","authors":"Isabella Cristina Mendes de Sá e Silva ,&nbsp;Carla Andrade Cardoso Tanuri Caldas ,&nbsp;Marisa Marcia Mussi-Pinhata ,&nbsp;Silvia Fabiana Biason de Moura Negrini ,&nbsp;Carolina Portugal ,&nbsp;Ana Paula Andrade Hamad ,&nbsp;NATZIG cohort study members","doi":"10.1016/j.earlhumdev.2025.106198","DOIUrl":"10.1016/j.earlhumdev.2025.106198","url":null,"abstract":"<div><div>The occurrence of motor dysfunctions was assessed at the age of 5 to 7 years in 61 normocephalic infants with prenatal Zika virus exposure. Traditional neurological examination, Touwen neurological examination, Movement Assessment Battery for Children-Second Edition (MABC-2) and the Developmental Coordination Disorder Questionnaire (DCDQ) were used to identify Developmental Coordination Disorder (DCD) and Minimal Neurological Dysfunction (MND). A high frequency of motor dysfunctions was found, 47 (81.0 %) of MND and 15 (24.5 %) of probable DCD. It is also possible to suggest some association between both conditions.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"201 ","pages":"Article 106198"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental trajectories in high-risk NICU graduates during the first year of life","authors":"Nicole M. McDonald ,&nbsp;Qi Qian ,&nbsp;Camila A. Ferrario ,&nbsp;Damla Senturk ,&nbsp;Sai Iyer ,&nbsp;Shafali S. Jeste","doi":"10.1016/j.earlhumdev.2024.106183","DOIUrl":"10.1016/j.earlhumdev.2024.106183","url":null,"abstract":"<div><h3>Objective</h3><div>We examined whether early medical factors predicted variability in developmental level and trajectories in high-risk neonatal intensive care unit (NICU) graduates during the first year of life.</div></div><div><h3>Method</h3><div>Infants (<em>n</em> = 53) who met criteria for the High-Risk Infant Follow-up Program were enrolled. Simple linear models predicted 12-month developmental abilities and linear mixed models predicted 6- to 12-month trajectories based on length of NICU stay and birthweight.</div></div><div><h3>Results</h3><div>Length of NICU stay was more clearly predictive of 12-month developmental level, while birthweight better explained variability in trajectories. Communication and daily living skills varied based on early medical factors, whereas social skills did not. Motor skills varied by length of stay but not birthweight.</div></div><div><h3>Conclusion</h3><div>Results support the need for close developmental monitoring of NICU graduates, particularly those with lengthier stays and lower birthweight. Developmental support needs should be based not just on current delays, but on the rate at which infants learn new skills.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"201 ","pages":"Article 106183"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of the DF-MOT to detect motor developmental delays in preterm children: A comparative study with the Bayley-III","authors":"Ludovic Legros ,&nbsp;Gilda Delens ,&nbsp;Sophie Zaczek ,&nbsp;Marie Alexandre ,&nbsp;Laurence Vaivre-Douret","doi":"10.1016/j.earlhumdev.2025.106206","DOIUrl":"10.1016/j.earlhumdev.2025.106206","url":null,"abstract":"<div><h3>Background</h3><div>The Motor Functional Development Scale for Young Children (DF-MOT) is a motor developmental scale originally designed and standardized for full-term children.</div></div><div><h3>Aim</h3><div>To validate the DF-MOT for diagnosing motor delays in preterm children, using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), as a reference.</div></div><div><h3>Study design</h3><div>Prospective concurrent validity study.</div></div><div><h3>Method</h3><div>Seventy-six preterm children born before 32 weeks' gestational age were concurrently assessed at corrected ages of 9 to 30 months using the DF-MOT and the Bayley-III. Validation of the DF-MOT involved a three-step process: (1) raw and standardized scores correlation analysis, (2) receiver-operating characteristic (ROC) curve analysis to assess diagnostic accuracy, and (3) diagnostic properties analysis for the primary DF-MOT cut-offs.</div></div><div><h3>Results</h3><div>Correlation analysis demonstrated very strong correlation for both gross and fine motor raw scores (<strong><em>r</em></strong> = 0.95 and 0.94, respectively), and strong to weak correlation for the standardized scores (ρ = 0.66 and 0.28, respectively). The DF-MOT gross motor subscale (DF-MOT/PML) exhibited excellent diagnostic accuracy on the ROC curve analysis and good diagnostic properties at −1 standard deviation, while the fine motor subscale (DF-MOT/EHGC) appeared to be less accurate in diagnosing delay with the Bayley-III. This disparity in fine motor evaluation seems to be linked to the DF-MOT/EHGC's greater sensitivity to identify fine motor delays.</div></div><div><h3>Conclusion</h3><div>The DF-MOT is a valid developmental tool for assessing motor skills in preterm children, offering enhanced sensitivity in detecting fine motor delays. It may provide practitioners with in-depth, development-focused assessments.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"202 ","pages":"Article 106206"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary biomarkers in neonates born to mothers with preeclampsia: A case-control study","authors":"Praveen Kumar ,&nbsp;Vimal Master Sankar Raj ,&nbsp;Diana Warnecke ,&nbsp;Manu Gnanamony ,&nbsp;Sarah E. Donohue","doi":"10.1016/j.earlhumdev.2024.106169","DOIUrl":"10.1016/j.earlhumdev.2024.106169","url":null,"abstract":"<div><h3>Background</h3><div>Effects of preeclampsia (PE) on fetal renal development are unknown. We hypothesized that the circulating factors causing endothelial dysfunction and impaired renal function in mothers with PE adversely affect fetal kidneys.</div></div><div><h3>Objective</h3><div>To compare urinary biomarkers in infants born to mothers with and without PE.</div></div><div><h3>Methods</h3><div>Sixty-eight mothers and their newborns with gestational age ≥ 32 weeks were enrolled. We collected bag urine samples from infants during the first 48 h of life. Urine samples were centrifuged at 1500 rpm for 10 min. Supernatant after excluding the bottom 1 mL of urine was stored at −70 °C until assayed. Urinary creatinine, protein, cystatin C, nephrin, kidney injury molecule – 1, and klotho were measured.</div></div><div><h3>Results</h3><div>Sixteen mothers in the PE group had severe features of PE. The PE group infants had lower body length compared to the control group (46.4 ± 3.4 vs 48.6 ± 3.4 cm; <em>p</em> = 0.007). Urine protein and creatinine were significantly higher in the PE group infants [protein 37.1 (14.4, 53.5) vs 20.3 (7.5, 30.0) mg/dl, <em>p</em> = 0.04; creatinine 63.4 (25.2, 96.6) vs 24.8 (19.8, 44.2) mg/dl, <em>p</em> = 0.008]. There were no statistically significant differences in the urinary concentrations of the remaining four biomarkers. The urinary protein, creatinine and nephrin concentrations had significant negative correlation with gestational age (<em>p</em> values 0.07, 0.0003 and 0.0008 respectively).</div></div><div><h3>Conclusions</h3><div>The findings of higher urinary protein and the observed trends in the levels of urinary nephrin and klotho are suggestive of glomerular immaturity and/or impaired function in infants born to mothers with PE.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106169"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative analysis of fetal cardiac structure and function in gestational diabetes mellitus using fetal HQ technology","authors":"Yao Peng ,&nbsp;Wei Feng ,&nbsp;Zixian Wei ,&nbsp;Xue Liao ,&nbsp;Yang He ,&nbsp;Caihong Chang ,&nbsp;Ling Gan ,&nbsp;Jiaqi Zhang","doi":"10.1016/j.earlhumdev.2024.106168","DOIUrl":"10.1016/j.earlhumdev.2024.106168","url":null,"abstract":"<div><h3>Background</h3><div>Gestational diabetes mellitus (GDM) can contribute to changes in fetal cardiac structure and function, with potential implications for long-term cardiovascular health. This study focuses on assessing these cardiac adaptations in fetuses from GDM pregnancies by using the innovative Fetal Heart Quantification (Fetal HQ) technology to provide a detailed evaluation of structural and functional parameters.</div></div><div><h3>Methods</h3><div>A prospective study was conducted from March 2023 to October 2024 at Xiangyang No.1 People's Hospital, involving 382 pregnant women in their second and third trimesters, including 167 with GDM and 215 healthy controls. Fetal cardiac assessments were performed using Fetal HQ, which allows for direct measurement of cardiac deformation and function. Key parameters such as left ventricular (LV) and right ventricular (RV) dimensions, global longitudinal strain (GLS), and fractional area change (FAC) were analyzed. Maternal clinical data, including blood glucose levels and body mass index (BMI), were also collected. Statistical analyses were performed to compare the cardiac parameters between the two groups.</div></div><div><h3>Results</h3><div>Significant differences were observed in fetal cardiac dimensions, with the GDM group exhibiting larger LV end-diastolic area (2.04 ± 0.73 cm² vs. 1.81 ± 0.69 cm², <em>p</em> = 0.002) and lower RV GLS (−20.1 ± 5.3 % vs. -22.6 ± 4.6 %, <em>p</em> = 0.000). Other functional parameters, including LV GLS and FAC, did not show significant differences between groups. Correlation analysis revealed a significant positive relationship between maternal HbA1c levels and RV FAC (<em>r</em> = 0.348, <em>p</em> = 0.036), indicating that maternal glycemic control may influence fetal cardiac function.</div></div><div><h3>Conclusions</h3><div>The findings suggest that GDM is associated with altered fetal cardiac morphology, particularly in the left ventricle, and impaired right ventricular function, as evidenced by reduced GLS. These results highlight the potential impact of maternal hyperglycemia on fetal cardiac development and underscore the importance of monitoring fetal cardiac health in pregnancies complicated by GDM. The use of Fetal HQ technology provides a valuable tool for early detection of cardiac dysfunction in this high-risk population.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"200 ","pages":"Article 106168"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}