Gynecology and Obstetrics Service, Mário Palmério University Hospital, University of Uberaba (UNIUBE), Uberaba-MG, Brazil.
Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba-MG, Brazil.
Cardiol Young. 2024 Feb;34(2):319-324. doi: 10.1017/S1047951123001609. Epub 2023 Jul 6.
To assess the impact of overweight and obesity in the second and third trimesters of pregnancy on fetal cardiac function parameters.
We performed a prospective cohort study of 374 singleton pregnant women between 20w0d and 36w6d divided into three groups: 154 controls (body mass index - BMI < 25 kg/m), 140 overweight (BMI 25-30 kg/m) and 80 obese (BMI ≥ 30 kg/m). Fetal left ventricular (LV) modified myocardial performance index (Mod-MPI) was calculated according to the following formula: (isovolumetric contraction time + isovolumetric relaxation time)/ejection time. Spectral tissue Doppler was used to determine LV and right ventricular (RV) myocardial performance index (MPI'), peak myocardial velocity during systole (S'), early diastole (E'), and late diastole (A').
We found significant differences between the groups in maternal age (p < 0.001), maternal weight (p < 0.001), BMI (p < 0.001), number of pregnancies (p < 0.001), parity (p < 0.001), gestational age (p = 0.013), and estimated fetal weight (p = 0.003). Overweight pregnant women had higher LV Mod-MPI (0.046 versus 0.044 seconds, p = 0.009) and LV MPI' (0.50 versus 0.47 seconds, p < 0.001) than the control group. Obese pregnant women had higher RV E' than control (6.82 versus 6.33 cm/sec, p = 0.008) and overweight (6.82 versus 6.46 cm/sec, p = 0.047) groups. There were no differences in 5-min APGAR score < 7, neonatal intensive care unit admission, hypoglycemia and hyperglobulinemia between the groups.
We observed fetal myocardial dysfunction in overweight and obese pregnant women with higher LV Mod-MPI, LV MPI' and RV E' compared to fetuses from normal weight pregnant women.
评估妊娠中、晚期超重和肥胖对胎儿心功能参数的影响。
我们对 374 名 20w0d 至 36w6d 的单胎孕妇进行了前瞻性队列研究，将其分为三组：154 例对照组（体重指数 - BMI < 25kg/m）、140 例超重组（BMI 25-30kg/m）和 80 例肥胖组（BMI ≥ 30kg/m）。根据以下公式计算胎儿左心室（LV）改良心肌做功指数（Mod-MPI）：（等容收缩时间+等容舒张时间）/射血时间。采用频谱组织多普勒测定 LV 和右心室（RV）心肌做功指数（MPI'）、收缩期峰值心肌速度（S'）、舒张早期（E'）和舒张晚期（A'）。
我们发现各组间在产妇年龄（p<0.001）、产妇体重（p<0.001）、BMI（p<0.001）、孕次（p<0.001）、产次（p<0.001）、孕龄（p=0.013）和估计胎儿体重（p=0.003）方面存在显著差异。与对照组相比，超重孕妇的 LV Mod-MPI（0.046 秒比 0.044 秒，p=0.009）和 LV MPI'（0.50 秒比 0.47 秒，p<0.001）更高。肥胖孕妇的 RV E'高于对照组（6.82 厘米/秒比 6.33 厘米/秒，p=0.008）和超重组（6.82 厘米/秒比 6.46 厘米/秒，p=0.047）。各组间 5 分钟 Apgar 评分<7、新生儿重症监护病房入院、低血糖和高球蛋白血症无差异。
与正常体重孕妇相比，超重和肥胖孕妇的胎儿心肌功能受损，LV Mod-MPI、LV MPI'和 RV E'较高。
