Department of Obstetrics and Gynecology, Istanbul Medipol University, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Perinatology Division, Hacettepe University, Ankara, Turkey.
J Obstet Gynaecol. 2021 Feb;41(2):224-228. doi: 10.1080/01443615.2020.1732895. Epub 2020 Apr 14.
Estimation of foetal weight in the prenatal period is important in many respects. For this purpose, during different periods of pregnancy; mostly in the last trimester; many methods or formulas have been described, almost of them using ultrasound. Foetal epicardial adipose tissue has previously been described as a metabolic organ in studies. Foetal epicardial fat tissue thickness (EFT) measurement has been previously described in the literature and has been associated with metabolic conditions such as preeclampsia or gestational diabetes. The purpose of this study was to determine the strength and cut-off value of EFT measured by ultrasound in the second trimester in the prediction of large for gestational age (LGA) foetuses. Epicardial fat tissue thicknesses which were recorded during second trimester anomaly screening were evaluated retrospectively. Birth weights of the same cases were also obtained from the database and analysed with IBM SPSS Statistics for Windows Version 22.0 (IBM Corp., Armonk, NY, USA). LGA babies had thicker EFT measurements and we established a cut-off EFT value of 1.38 mm. Our results suggest that EFT thickness measured by ultrasound in the second trimester may be useful in predicting LGA foetuses.Impact statement It is known that foetal epicardial fat tissue is an adipose tissue with metabolic functions. Previously the relationship between this tissue and prenatal complications; such as, preeclampsia, gestational diabetes and infant growth and development were investigated. We planned this study considering that a tissue with metabolic functions affecting foetal growth may also affect birth weight. Foetal epicardial fat thickness measurement only once in the second trimester may predict the 90th percentile limit at birth which is considered as the LGA limit. In our study, we determined that the thickness of epicardial fat tissue measured in the second tirmester could predict the 90 th percentile limit at birth and that the cut-off value for this group was 1.38 mm. We believe that this measurement may help to determine LGA babies at birth as early as the second trimester. In future studies, the 97 percentile limit can be determined from the early weeks with reaching larger groups. Thus, babies who are likely to experience birth trauma in clinical practice can be reached from early weeks.
在产前阶段估计胎儿体重在很多方面都很重要。为此，在不同的孕期；主要在孕晚期；已经描述了几乎所有的方法或公式，其中大多数都使用了超声。在之前的研究中，胎儿的心外膜脂肪组织被描述为一种代谢器官。胎儿的心外膜脂肪组织厚度（EFT）的测量在文献中已有描述，并与代谢状况如子痫前期或妊娠期糖尿病有关。本研究的目的是确定在预测巨大儿（LGA）胎儿时，在孕中期通过超声测量的 EFT 的强度和截断值。回顾性评估了在孕中期异常筛查期间记录的心外膜脂肪组织厚度。还从数据库中获得了相同病例的出生体重，并使用 IBM SPSS Statistics for Windows Version 22.0（IBM Corp.，Armonk，NY，USA）进行分析。LGA 婴儿的 EFT 测量值较厚，我们建立了 1.38mm 的截断 EFT 值。我们的结果表明，在孕中期通过超声测量的 EFT 厚度可能有助于预测 LGA 胎儿。
影响声明
已知胎儿的心外膜脂肪组织是一种具有代谢功能的脂肪组织。之前曾研究过这种组织与产前并发症之间的关系，例如子痫前期、妊娠期糖尿病以及婴儿的生长发育。考虑到影响胎儿生长的具有代谢功能的组织也可能影响出生体重，我们计划了这项研究。在孕中期仅测量一次胎儿心外膜脂肪厚度，即可预测出生时的第 90 百分位数上限，该值被认为是 LGA 的上限。在我们的研究中，我们确定在孕中期测量的心外膜脂肪组织厚度可以预测出生时的第 90 百分位数上限，该组的截断值为 1.38mm。我们认为，这种测量方法可以帮助在孕中期尽早确定 LGA 婴儿。在未来的研究中，可以从早期几周通过更大的群体来确定第 97 百分位数上限。这样，就可以从早期接触到那些在临床实践中可能会经历分娩创伤的婴儿。
