Fetal cardiac alterations in the late-onset growth-restricted fetuses: A prospective case-control study

J Obstet Gynaecol Res. 2022 Feb;48(2):373-378. doi: 10.1111/jog.15114. Epub 2021 Nov 28.

Abstract

Aim: Fetal growth restriction (FGR) has significant consequences on cardiac functions. This study aims to evaluate cardiac functional parameters in late-onset (FGR) fetuses and compare those appropriate for gestational age (AGA) fetuses.

Material and methods: Fifty-six singleton pregnancies were involved in this prospective case-control study. Delphi consensus was used to define late-onset FGR. We compared the E/A ratio, left myocardial performance index (MPI) and tricuspid annular plane systolic excursion (TAPSE) in late-onset FGR cases and gestational age-matched AGA fetuses.

Results: Twenty-eight late-onset FGR and 28 AGA fetuses were enrolled. The mean gestational age in the late-onset FGR group was 34.1 ± 2.3 weeks and 34.4 ± 2.1 in controls. The E/A ratio was 0.88 ± 0.09 in AGA fetuses, 0.79 ± 0.11 in the late-onset FGR group, and significantly lower in late-onset FGR fetuses (p: 0.012). Left MPI was 0.51 ± 0.09 in AGA and 0.62 ± 0.11 in the late-onset FGR group. Left MPI was markedly higher in late-onset FGR fetuses (p: 0.024). TAPSE was 7.4 ± 2.9 mm in controls and 5.2 ± 1.8 in the late-onset FGR group, and it was significantly shorter in the late-onset FGR fetuses (p: 0.016).

Conclusion: Late-onset FGR is associated with cardiac remodeling and dysfunction. Fetal echocardiography may be beneficial to detect those subtle cardiac changes.

Keywords: MPI; TAPSE; echocardiography; intrauterine growth restriction.

MeSH terms

  • Case-Control Studies
  • Female
  • Fetal Growth Retardation / diagnostic imaging
  • Fetal Heart* / diagnostic imaging
  • Gestational Age
  • Humans
  • Infant
  • Pregnancy
  • Prospective Studies
  • Ultrasonography, Prenatal*