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Growth patterns in fetuses with isolated cardiac defects

Ilse Haveman1, Johanna H Fleurke-Rozema2, Eduard J H Mulder1

  • 1Department of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht, The Netherlands.

Prenatal Diagnosis
|March 3, 2018
PubMed

Insights

Fetal head growth slightly decreases in fetuses with congenital heart defects (CHDs), but abdominal circumference and femur length remain unaffected. Specific heart defect types may impact head circumference more significantly.

Area of Science:

  • Prenatal diagnosis
  • Fetal medicine
  • Pediatric cardiology

Background:

  • Congenital heart defects (CHDs) can impact fetal development.
  • Longitudinal growth data for parameters beyond head circumference in fetuses with CHDs are limited.

Purpose of the Study:

  • To assess longitudinal growth patterns of fetal biometry, including abdominal circumference (AC) and femur length (FL), in fetuses with isolated CHDs diagnosed prenatally.
  • To analyze growth differences across various categories of isolated CHDs.

Main Methods:

  • Retrospective study of 246 live births with isolated CHDs diagnosed prenatally.
  • Fetal biometry parameters (head circumference [HC], AC, FL) assessed at multiple time points (18-35 weeks' gestation).
  • Linear mixed modeling used to construct growth models and analyze repeated measurements, with parameters transformed into Z scores.

Main Results:

  • A modest but significant linear decrease in head circumference (HC) growth was observed in the second half of pregnancy for fetuses with CHDs.
  • Abdominal circumference (AC) and femur length (FL) growth trajectories were not significantly affected.
  • Fetal growth modeling predicted a significantly smaller HC at 36 weeks' gestation specifically in fetuses with conotruncal heart defects.

Conclusions:

  • Fetuses with CHDs exhibit a significant, albeit modest, linear decrease in HC growth during gestation.
  • Growth patterns for AC and FL remain stable in fetuses with isolated CHDs.
  • Specific CHD types, such as conotruncal defects, may be associated with more pronounced effects on fetal head growth.
Abstract

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