| Objective:Fetal growth restriction(FGR)refers to the inability of the fetus to reach its growth potential due to various adverse factors.It is defined as an estimated fetal weight or abdominal circumference below the 10th percentile for the gestational age on ultrasound in China practice guideline.FGR is the second leading cause of perinatal mortality,and the growth restriction of fetal organs can lead to adverse perinatal outcomes and long-term negative consequences for children and adults,especially for the cardiovascular system.This can manifest as abnormal heart morphology and function in the fetal period.The aim of this study is to evaluate the effect of FGR on fetal heart morphology and function using ultrasound Doppler and fetal heart quantification analysis technology(Fetal Heart quantification,fetal HQ),as well as to assess the correlation of these parameters with maternal age,BMI,gestational age,and newborn birth weight,in order to provide recommendations for the clinical management of FGR fetuses.Methods:This is a prospective cohort study which included 160 singleton pregnant women who underwent prenatal checkups at Zhujiang Hospital of Southern Medical University Hospital between June 2021 and June 2022.The FGR group consisted of 50 cases(31.24±3.67 gestational weeks),while the control group consisted of 110 cases(30.89±2.70 gestational weeks).We measured UA-PI,MCA-PI,and Tei index,and calculated CPR by ultrasound Doppler for all fetuses,and GSI,FAC,GLS,24-segment SI,EDD,and FS by fetal HQ.The normality of all data was tested,and the t-test or Mann-Whitney U test was used to compare the differences in parameters between the two groups.Pearson correlation analysis was used to evaluate the correlation between the primary Doppler and fetal HQ parameters and maternal age,BMI,gestational age,and newborn birth weight in both groups.The statistical significance level was set at P<0.05.Results:1.There was no significant difference between the general information of the two groups,and newborn birth weight with FGR was significantly lower than that of the control group(P<0.05).2.GSI,GLS,and FAC were lower in FGR than in the control group,and the EDD of each segment of the right and left ventricles was higher than in the control group(P<0.05).3.The GSI,GLS,and FAC of the FGR group were lower than those of the control group(P<0.05).The EDD of the left and right ventricles of the FGR group were higher than those of the control group,except for RV-EDD in Seg-17,18,and 24 segments,which showed no statistical difference(P>0.05).The EDD of other segments showed statistical differences(P<0.05).The 24-segment SI of the left and right ventricles of both groups showed no statistical difference(P>0.05).In Seg2-7 and Seg22-24 segments,the LV-FS of the FGR group was lower than that of the control group.In Seg8-21 segments,the LV-FS of the FGR group was higher than that of the control group.In Seg3-24 segments,the RV-FS of the FGR group was lower than that of the control group(P<0.05).4.The Tei index of both the early-onset FGR group and the late-onset FGR group were higher than that of the control group,while CPR,GSI,LV-GLS,RV-GLS,LV-FAC and RV-FAC were lower than that of the control group.The difference between the early-onset FGR and control groups was more significant than that of the late-onset FGR.5.The RV-GLS of the FGR group was related to maternal age,and the LV-FAC was related to maternal age and newborn birth weight of the fetus.Conclusion:1.In the FGR group,CPR and GSI of fetuses,GLS and FAC of left and right ventricles were lower than those in the control group.Tei index and EDD of each segment were higher than those in the control group.The cardiac morphology was closer to "spherical".2.FS of left ventricle in FGR group was lower than that in the control group during segments 1-7 and 22-24,while it was higher than that in the control group during segments 8-21.FS of right ventricle in FGR group was lower than that in the control group during all segments.3.The damage to fetal heart is more severe in early-onset FGR compared to late-onset FGR.4.The parameters of GLS and FAC may have certain correlations with maternal age,gestational weeks,and fetal birth weight,while GSI is not affected by these factors. |
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