Biały Łucja Hanna, Sylwestrzak Oskar, Murlewska Julia, Sokołowski Łukasz, Strzelecka Iwona, Respondek-Liberska Maria
Students' Prenatal Cardiology Scientific Group, Medical University of Łódź, 92-213 Łódź, Poland.
Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, 93-338 Łódź, Poland.
J Clin Med. 2025 Jun 25;14(13):4500. doi: 10.3390/jcm14134500.
: The aim of this study was to determine the prevalence of functional cardiovascular anomalies detected on fetal echocardiography in third-trimester large-for-gestational-age (LGA) fetuses, who were subsequently born as macrosomic newborns with a birth weight exceeding 4000 g. : A retrospective study was conducted on 1002 fetuses examined during the third trimester at our fetal cardiology center between 2018 and 2024. All fetuses were classified as having "normal heart anatomy" (NHA). Statistical analysis was performed using Microsoft Excel 2024, Statistica 13.1, and EasyMedStat (version 3.37.1). A -value of <0.05 was considered statistically significant. : The 1002 fetuses were divided into two groups. The study group (NHA-LGA) consisted of 167 fetuses born with a weight of >4000 g and the control group (NHA-AGA) was made up of 835 fetuses with a birth weight between 2500 and 4000 g. In the NHA-LGA group, 24 fetuses (14.4%) experienced ductal constriction (DC), while in the NHA-AGA group, it was 11 (1.3%) fetuses ( < 0.00001). Myocardial hypertrophy was observed in 30 fetuses (18.0%) in the NHA-LGA group versus 72 (8.6%) in the NHA-AGA group ( < 0.0003). Additionally, cardiomegaly was noted in 95 fetuses (11.4%) in the NHA-LGA group, compared to 37 (4.4%) in the NHA-AGA group ( < 0.0004). : LGA fetuses with normal heart anatomy may present with functional cardiovascular anomalies, including ductal constriction, myocardial hypertrophy, and cardiomegaly. In our cohort, such anomalies were identified in up to 51% of cases. These findings suggest that targeted fetal echocardiographic screening in macrosomic fetuses could be clinically valuable, even in the absence of structural heart defects, and may aid in the early identification of functional cardiac alterations that could impact perinatal management.
本研究的目的是确定孕晚期大于胎龄儿（LGA）胎儿在胎儿超声心动图检查中发现的功能性心血管异常的患病率，这些胎儿随后出生为出生体重超过4000g的巨大儿。
对2018年至2024年期间在我们胎儿心脏病中心孕晚期接受检查的1002例胎儿进行了一项回顾性研究。所有胎儿均被分类为具有“正常心脏解剖结构”（NHA）。使用Microsoft Excel 2024、Statistica 13.1和EasyMedStat（版本3.37.1）进行统计分析。P值<0.05被认为具有统计学意义。
1002例胎儿分为两组。研究组（NHA-LGA）由167例出生体重>4000g的胎儿组成，对照组（NHA-AGA）由835例出生体重在2500至4000g之间的胎儿组成。在NHA-LGA组中，24例胎儿（14.4%）出现导管狭窄（DC），而在NHA-AGA组中，有11例（1.3%）胎儿出现导管狭窄（P<0.00001）。NHA-LGA组中有30例胎儿（18.0%）观察到心肌肥厚，而NHA-AGA组中有72例（8.6%）（P<0.0003）。此外，NHA-LGA组中有95例胎儿（11.4%）出现心脏扩大，而NHA-AGA组中有37例（4.4%）（P<0.0004）。
具有正常心脏解剖结构的LGA胎儿可能存在功能性心血管异常，包括导管狭窄、心肌肥厚和心脏扩大。在我们的队列中，高达51%的病例中发现了此类异常。这些发现表明，即使在没有结构性心脏缺陷的情况下，对巨大儿进行针对性的胎儿超声心动图筛查在临床上可能具有重要价值，并且可能有助于早期识别可能影响围产期管理的功能性心脏改变。
