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肥胖孕妇胎儿皮质发育和神经超声表现:来自一家三甲医院的病例对照研究。

Fetal cortical development and neurosonographic findings in obese pregnant women: a case control study from a tertiary hospital.

机构信息

Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Üniversiteler Mahallesi 1604. Cadde No: 9 Çankaya, Ankara, Turkey.

Department of Obstetrics and Gynecology, University of Health Sciences, Istanbul, Turkey.

出版信息

Arch Gynecol Obstet. 2024 Jul;310(1):83-91. doi: 10.1007/s00404-023-07258-4. Epub 2023 Oct 13.

Abstract

PURPOSE

To investigate the effect of obesity on fetal cortical development.

METHODS

This prospective cross-sectional study was conducted with 91 pregnant women. Fetal neurosonography scans were performed in the third trimester, and according to body mass index (BMI) values, the patients were evaluated in two groups: obese (BMI ≥ 30 kg/m) and normal weight (BMI < 30 kg/m). During neurosonography, fetal insular depth and Sylvian fissures, parieo-occipital and cingulate fissure depth, frontal lobe length, and the sizes of the corpus callosum and cavum septum pellucidum were measured using a transvaginal approach. Fetal cortical development and Sylvian fissure operculization were graded.

RESULTS

The number of patients with grade 2 fetal cortical development was significantly higher among the pregnant women in the obese group compared to the normal weight group (n = 17, 41.5% and n = 8, 16.0%, respectively; p = 0.007). In the obese group, the number of pregnant women with grade 4 or below fetal Sylvian fissure operculization was significantly higher (n = 13, 31.7%), and the number of those with grade 9 or above operculization was significantly lower (n = 1, 2.5%) (p = 0.003). The fetal insular depth, frontal lobe anterior-posterior diameter, cingulate fissure depth, and corpus callosum thickness were lower in the obese group, albeit with no significant difference. Parieto-occipital depth significantly decreased in the obese group [6.8 (6) mm)] compared to the control group [10.5 (7.2) mm)] (p = 0.008). The fetal Sylvian fissure ratio and the cavum septum pellucidum ratio were found to be similar between the groups.

CONCLUSION

The data obtained from this study showed that obesity caused fetal cortical changes in pregnant women.

摘要

目的

探讨肥胖对胎儿皮质发育的影响。

方法

本前瞻性横断面研究纳入了 91 名孕妇。在孕晚期进行胎儿神经超声检查,并根据体重指数(BMI)值将患者分为两组:肥胖组(BMI≥30kg/m²)和正常体重组(BMI<30kg/m²)。在神经超声检查中,经阴道途径测量胎儿脑岛深度和大脑外侧裂深度、顶枕部和扣带回裂深度、额叶长度以及胼胝体和透明隔腔的大小。采用分级方法评估胎儿皮质发育和大脑外侧裂覆盖情况。

结果

肥胖组中胎儿皮质发育为 2 级的孕妇数量明显多于正常体重组(n=17,41.5%和 n=8,16.0%;p=0.007)。肥胖组中,胎儿大脑外侧裂覆盖为 4 级或以下的孕妇数量明显较多(n=13,31.7%),而覆盖为 9 级或以上的孕妇数量明显较少(n=1,2.5%)(p=0.003)。肥胖组胎儿脑岛深度、额叶前后径、扣带回裂深度和胼胝体厚度较低,但无显著差异。顶枕裂深度在肥胖组明显降低[6.8(6)mm],与对照组[10.5(7.2)mm]相比差异有统计学意义(p=0.008)。两组间胎儿大脑外侧裂比和透明隔腔比无明显差异。

结论

本研究结果表明肥胖导致孕妇胎儿皮质发生变化。

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