Subscribe to RSS
DOI: 10.1055/a-2267-5478
Fetal Epicardial Fat Thickness in Obese Pregnant Women: Its Effect on Fetal Cardiac Function and Neonatal Outcomes
Clinical Trials Registration: ClinicialTrials.gov NCT05948319![](https://www.thieme-connect.de/media/zgn/EFirst/lookinside/thumbnails/09-2023-0818_10-1055-a-2267-5478-1.jpg)
Abstract
Objective This study aimed to evaluate fetal epicardial fat thickness (EFT) together with fetal myocardial performance index (MPI) and its effects on neonatal outcomes in obese pregnant women.
Materials and methods A total of 102 pregnant women, 51 obese and 51 of normal weight, were included in this prospective study. Fetal EFT, and MPI measurements were performed for all patients.
Results Fetal EFT and Mod-MPI showed a statistically significant difference between obese pregnant women and the control group (p=0.0001, p=0.001). The optimal fetal EFT predictive cut-off value for the 5th-minute APGAR score below 7 was 1.22 mm, with a sensitivity of 86.96% and a specificity of 54.43% (p=0.001).
Conclusion Fetal EFT and mod-MPI were higher in obese pregnant women. It is encouraging that fetal EFT predicts low APGAR, but more important information can be obtained if postnatal follow-up of these cardiac changes caused by obesity can be performed.
Publication History
Received: 09 September 2023
Accepted after revision: 01 February 2024
Article published online:
19 March 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Ece I, Uner A, Balli S. et al. The effects of pre-pregnancy obesity on fetal cardiac functions. Pediatr Cardiol 2014; 35: 838-843 DOI: 10.1007/s00246-014-0863-0.
- 2 Pritchard NL, Hiscock R, Walker SP. et al. Defining poor growth and stillbirth risk in pregnancy for infants of mothers with overweight and obesity. Am J Obstet Gynecol 2023; 229: 59e.1-59.e12 DOI: 10.1016/j.ajog.2022.12.322.
- 3 DeBolt CA, Sarker M, Trejo FE. et al. Association between obesity and fetal acidosis at scheduled cesarean delivery. Obstet Gynecol 2022; 140: 950-957 DOI: 10.1097/aog.0000000000004968.
- 4 Denison FC, Roberts KA, Barr SM. et al. Obesity, pregnancy, inflammation, and vascular function. Reproduction (Cambridge, England) 2010; 140: 373-385 DOI: 10.1530/rep-10-0074.
- 5 Quaresima P, Fesslova V, Farina A. et al. How to do a fetal cardiac scan. Arch Gynecol Obstet 2023; 307: 1269-1276 DOI: 10.1007/s00404-023-06951-8.
- 6 Api O, Emeksiz MB, Api M. et al. Modified myocardial performance index for evaluation of fetal cardiac function in pre-eclampsia. Ultrasound Obstet Gynecol 2009; 33: 51-57 DOI: 10.1002/uog.6272.
- 7 Talman AH, Psaltis PJ, Cameron JD. et al. Epicardial adipose tissue: far more than a fat depot. Cardiovasc Diagn Ther 2014; 4: 416-429 DOI: 10.3978/j.issn.2223-3652.2014.11.05.
- 8 Iacobellis G, Barbaro G. The double role of epicardial adipose tissue as pro- and anti-inflammatory organ. Horm Metab Res 2008; 40: 442-445 DOI: 10.1055/s-2008-1062724.
- 9 Akkurt MO, Turan OM, Crimmins S. et al. Increased fetal epicardial fat thickness: A novel ultrasound marker for altered fetal metabolism in diabetic pregnancies. J Clin Ultrasound 2018; 46: 397-402 DOI: 10.1002/jcu.22602.
- 10 [Anonymous] Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894 i–xii 1-253
- 11 Salomon LJ, Alfirevic Z, Berghella V. et al. ISUOG Practice Guidelines (updated): performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2022; 59: 840-856 DOI: 10.1002/uog.24888.
- 12 Hernandez-Andrade E, Figueroa-Diesel H, Kottman C. et al. Gestational-age-adjusted reference values for the modified myocardial performance index for evaluation of fetal left cardiac function. Ultrasound Obstet Gynecol 2007; 29: 321-325 DOI: 10.1002/uog.3947.
- 13 Kim SS, Zhu Y, Grantz KL. et al. Obstetric and neonatal risks among obese women without chronic disease. Obstet Gynecol 2016; 128: 104-112 DOI: 10.1097/aog.0000000000001465.
- 14 Chalouhi SE, Salafia C, Mikhail M. et al. Maternal body mass index does not affect neonatal umbilical artery blood gas parameters. J Pregnancy 2013; 2013: 654817 DOI: 10.1155/2013/654817.
- 15 Trojner-Bregar A, Blickstein I, Lucovnik M. et al. The relationship between cesarean section rate in term singleton pregnancies, maternal weight, and weight gain during pregnancy. J Perinat Med 2016; 44: 393-396 DOI: 10.1515/jpm-2015-0117.
- 16 Liu P, Xu L, Wang Y. et al. Association between perinatal outcomes and maternal pre-pregnancy body mass index. Obes Rev 2016; 17: 1091-1102 DOI: 10.1111/obr.12455.
- 17 Powell TL, Barner K, Madi L. et al. Sex-specific responses in placental fatty acid oxidation, esterification and transfer capacity to maternal obesity. Biochimica et Biophysica Acta Mol Cell Biol Lipids 2021; 1866: 158861 DOI: 10.1016/j.bbalip.2020.158861.
- 18 Hou WC, Chen JY, Huang HY. et al. Flow mediated dilatation of Taiwanese women with normal singleton pregnancies. Taiwan J Obstet Gynecol 2018; 57: 683-687 DOI: 10.1016/j.tjog.2018.08.012.
- 19 Huang L, Liu J, Feng L. et al. Maternal prepregnancy obesity is associated with higher risk of placental pathological lesions. Placenta 2014; 35: 563-569 DOI: 10.1016/j.placenta.2014.05.006.
- 20 Aksin S, Andan C, Tunc S. et al. Comparison of brachial artery flow-mediated dilatation, uterine artery Doppler, and umbilical artery Doppler measurements in obese and normal pregnant women. J Obstet Gynaecol Res 2022; 48: 340-350 DOI: 10.1111/jog.15092.
- 21 Sarno L, Maruotti GM, Saccone G. et al. Maternal body mass index influences umbilical artery Doppler velocimetry in physiologic pregnancies. Prenat Diagn 2015; 35: 125-128 DOI: 10.1002/pd.4499.
- 22 Kandadi MR, Hua Y, Zhu M. et al. Influence of gestational overfeeding on myocardial proinflammatory mediators in fetal sheep heart. J Nutr Biochem 2013; 24: 1982-1990 DOI: 10.1016/j.jnutbio.2013.07.003.
- 23 Kai H, Kuwahara F, Tokuda K. et al. Diastolic dysfunction in hypertensive hearts: roles of perivascular inflammation and reactive myocardial fibrosis. Hypertens Res 2005; 28: 483-490 DOI: 10.1291/hypres.28.483.
- 24 Ingul CB, Lorås L, Tegnander E. et al. Maternal obesity affects fetal myocardial function as early as in the first trimester. Ultrasound Obstet Gynecol 2016; 47: 433-442 DOI: 10.1002/uog.14841.
- 25 Rizzo G, Mattioli C, Mappa I. et al. Hemodynamic factors associated with fetal cardiac remodeling in late fetal growth restriction: a prospective study. J Perinat Med 2019; 47: 683-688 DOI: 10.1515/jpm-2019-0217.
- 26 Doğru Ş, Akkuş F. Fetal epicardial fat thickness in non-severe idiopathic polyhydramnios: Its impact on fetal cardiac function and perinatal outcomes. J Clin Ultrasound 2023; DOI: 10.1002/jcu.23476.. 10.1002/jcu.23476
- 27 Villasante Fricke AC, Iacobellis G. Epicardial adipose tissue: Clinical biomarker of cardio-metabolic risk. Int J Mol Sci 2019; 20 DOI: 10.3390/ijms20235989.
- 28 Jackson D, Deschamps D, Myers D. et al. Fetal epicardial fat thickness in diabetic and non-diabetic pregnancies: A retrospective cross-sectional study. Obesity (Silver Spring) 2016; 24: 167-171 DOI: 10.1002/oby.21353.
- 29 Yavuz A, Akkurt MO, Yalcin S. et al. Second trimester fetal and maternal epicardial fat thickness in gestational diabetic pregnancies. Horm Metab Res 2016; 48: 595-600 DOI: 10.1055/s-0042-111435.