Department of Obstetrics and Fetal Medicine, University Medical-Centre Hamburg Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Institute of Medical Biometry and Epidemiology, University Medical-Centre Hamburg Eppendorf, Hamburg, Germany.
BMC Pregnancy Childbirth. 2020 Sep 29;20(1):570. doi: 10.1186/s12884-020-03255-6.
The fetal adrenal gland receives rising awareness as a predictor of spontaneous preterm birth. We hereby provide longitudinal growth assessments of the fetal adrenal gland in a low risk population with an additional focus on trajectories in fetuses born preterm.
Fetal adrenal gland was assessed via transabdominal ultrasound at gestational weeks (gw) 24-26, 28-30, and 34-36 in a low-risk pregnancy cohort. Longitudinal trajectories of the total gland and the mark (so called fetal zone) as well as ratio of fetal zone width/ total widths (w/W) were analyzed using repeated ANOVA analyses. To compare trajectories of the ratio w/W for preterm and term fetuses respectively, as well as women with and without clinical signs of preterm labor, the propensity score method was applied.
Fetal zone width increased over the course of pregnancy (p < 0.0001), while the ratio w/W decreased (p < 0.0001) (n = 327). Comparing the trajectories of the ratio w/W in fetuses born preterm (n = 11) with propensity-score matched term born fetuses (n = 22), a decrease between gw 24-26 and 28-30 was observed in both groups, which continued to decrease for the term born fetuses. However, in preterm born fetuses, the ratio increased above the term born values at gw 34-36.
Our study provides for the first time longitudinal growth data on the fetal adrenal gland and supports the hypothesis that fetal zone enlargement is associated with preterm birth which could play an important role in risk-prediction.
胎儿肾上腺作为自发性早产预测因子受到越来越多的关注。本研究旨在为低危人群提供胎儿肾上腺的纵向生长评估，并特别关注早产儿的生长轨迹。
在低危妊娠队列中，于妊娠 24-26、28-30 和 34-36 周时通过经腹超声评估胎儿肾上腺。使用重复方差分析对总腺体和标记（所谓的胎儿区）以及胎儿区宽度/总宽度比（w/W）的纵向轨迹进行分析。为了比较早产儿和足月儿以及有或无早产临床迹象的孕妇的 w/W 比值的轨迹，应用倾向评分法。
胎儿区宽度随妊娠进展而增加（p<0.0001），而 w/W 比值降低（p<0.0001）（n=327）。比较早产儿（n=11）和倾向评分匹配的足月儿（n=22）出生的胎儿 w/W 比值的轨迹，两组在 24-26 和 28-30 周之间均观察到下降，而足月儿继续下降。然而，在早产儿中，在 34-36 周时，w/W 比值增加超过足月儿的值。
本研究首次提供了胎儿肾上腺的纵向生长数据，并支持胎儿区增大与早产相关的假设，这可能在风险预测中发挥重要作用。
