Department of Ultrasound, JinHua Maternal and Child Health Care Hospital, Jinhua, China.
Department of Ultrasound, JinHua Municipal Central Hospital, Jinhua, China.
J Matern Fetal Neonatal Med. 2024 Dec;37(1):2404985. doi: 10.1080/14767058.2024.2404985. Epub 2024 Sep 19.
Pregnancy-induced hypertension remains one of the important types of diseases that affect maternal and infant outcomes; prenatal and perinatal ultrasound examination is an important tool for evaluating fetal development. So, this study aimed to explore the clinical value of applying fetal heart quantification (fetal HQ) measuring left ventricular global longitudinal strain (LVGLS) and left ventricular ejection fraction (LVEF) in mid-to-late fetuses to predict neonatal complications in patients with gestational hypertension.
A retrospective summary of 146 pregnant women with gestational hypertension diagnosed from August 2020 to October 2023 into JinHua Maternal and Child Health Care Hospital was performed. Fetal HQ measured the fetal global spherical index (GSI), left and right ventricular spherical index (SI), left and right ventricular fractional shortening (FS), LVGLS and RVGLS, LVEF, and fractional area change (FAC) of the left and right ventricles. They were divided into complication group and non-complication group based on whether fetal complications occurred 28 days after birth. Multivariate logistic regression was used to screen risk factors to neonatal complications.
The 146 neonates were divided into 39 of the complication group and 107 of the non-complication group. Compared with the latter group, pregnant women in the former group had a higher incidence of preeclampsia and eclampsia, increased mean systolic and diastolic blood pressure, significantly lower estimated fetal weight (EFW), left ventricular 24-segment SI, LVGLS, LVEF, and left ventricular FAC values ( < .05). Logistic regression showed higher of LVGLS (adjusted OR = 2.281, < .001) was risk factors for neonatal complications, while higher LVEF (adjusted OR = 0.600, < .001) and left ventricular FAC (adjusted OR = 0.784, = .035) were protective factors. Spearman's correlation analysis showed a significant negative correlation between LVGLS and LVEF ( = -0.368, < .001). Receiver operating curves (ROCs) showed the area under the curve (AUC) for predicting overall neonatal complications was 0.880 for LVGLS and 0.878 for LVEF ( < .001).
Fetal HQ for fetal LVGLS and LVEF in mid-to-late pregnancy with gestational hypertension helps to assess the overall neonatal complications risk.
妊娠高血压仍然是影响母婴结局的重要疾病类型之一；产前和围产期超声检查是评估胎儿发育的重要工具。因此，本研究旨在探讨应用胎儿心量化（fetal HQ）测量左心室整体纵向应变（LVGLS）和左心室射血分数（LVEF）来预测妊娠高血压患者中晚期胎儿新生儿并发症的临床价值。
对 2020 年 8 月至 2023 年 10 月在金华市妇幼保健院诊断为妊娠高血压的 146 名孕妇进行回顾性总结。胎儿 HQ 测量胎儿整体球形指数（GSI）、左右心室球形指数（SI）、左右心室缩短分数（FS）、LVGLS 和 RVGLS、LVEF 和左右心室的分数面积变化（FAC）。根据出生后 28 天是否发生胎儿并发症，将其分为并发症组和非并发症组。采用多变量逻辑回归筛选新生儿并发症的危险因素。
146 例新生儿分为并发症组 39 例和非并发症组 107 例。与后者相比，前者孕妇子痫前期和子痫发生率较高，平均收缩压和舒张压较高，估计胎儿体重（EFW）、左心室 24 节段 SI、LVGLS、LVEF 和左心室 FAC 值明显降低（均<.05）。Logistic 回归显示，LVGLS 较高（调整 OR=2.281，<.001）是新生儿并发症的危险因素，而 LVEF 较高（调整 OR=0.600，<.001）和左心室 FAC 较高（调整 OR=0.784，=.035）是保护因素。Spearman 相关分析显示，LVGLS 与 LVEF 呈显著负相关（=-.368，<.001）。受试者工作特征曲线（ROCs）显示，LVGLS 预测新生儿并发症的总 AUC 为 0.880，LVEF 为 0.878（均<.001）。
妊娠高血压中晚期胎儿 HQ 测量胎儿 LVGLS 和 LVEF 有助于评估新生儿总体并发症风险。
