Fetal ventricular contractility and birth outcomes: a prospective cohort study

Area of Science:

• Maternal-fetal medicine
• Fetal cardiology
• Pregnancy complications

Background:

• Preeclampsia, gestational diabetes mellitus (GDM), and fetal growth restriction (FGR) impact fetal development and cardiovascular adaptation.
• Early identification of fetuses at risk for adverse outcomes is crucial for timely intervention.

Purpose of the Study:

• To investigate if early fetal cardiac function assessed via echocardiography can predict birth weight, gestational age, and pregnancy complications.
• To identify potential early biomarkers for adverse pregnancy outcomes.

Main Methods:

• Prospective cohort study of 101 singleton pregnancies evaluated at 20-22 weeks gestation.
• Detailed fetal echocardiography assessed ventricular size, systolic function, stroke volume, and cardiac output.
• Multivariate linear regression analyzed predictors of birth weight, gestational age, and complications, considering maternal factors like BMI.

Main Results:

• Fetuses of preeclamptic mothers showed smaller ventricular dimensions; FGR fetuses had smaller left ventricular end-diastolic and right ventricular end-systolic areas.
• No significant fetal heart defects or birth weight alterations were linked to GDM.
• Maternal BMI strongly predicted birth weight (p<0.001), while fetal cardiac parameters did not predict birth weight or gestational age.

Conclusions:

• Subclinical structural cardiac variations in preeclampsia and FGR indicate early remodeling without functional deficits.
• These findings highlight the need for targeted attention in high-risk pregnancies.
• Pre-pregnancy weight optimization strategies are recommended.