Perinatal & Pediatric
Three-dimensional fetal body composition and organ volume growth patterns across pregnancy-associated hypertensive disorders Kathryn Wagner* Kathryn Wagner Jessica Gleason Zhen Chen Stefanie Hinkle William Grobman Roger Newman Wesley Lee John Owen Daniel He Seth Sherman Robert Gore-Langton Luis Goncalves Daniel Skupski Edward Chien Ronald Wapner Sabrina Craigo Magdalena Sanz Cortes Angela Ranzini Anthony Sciscione Lauren Mack Jimmy Espinoza Mary D’Alton Michael Nageotte Cuilin Zhang Jagteshwar Grewal Katherine Grantz
Hypertensive disorders of pregnancy (HDP), which complicate 5-8% of pregnancies, are associated with lower birthweight and fetal growth restriction. Differential accumulation of fetal lean and fat tissue, and organ volume growth, may better define normal versus abnormal fetal growth. No studies have evaluated the association between HDP and three-dimensional (3D) measures of fetal body composition or organ volumes across pregnancy.
In the NICHD Fetal 3D Study (n=2425 pregnancies), fetal body composition and organ volumes were measured at up to five 3D ultrasound scans between 15 to 40 weeks. Women were identified as having severe preeclampsia (PE) (n=32, 1.3%), mild PE (n=51, 2.1%), gestational hypertension (GH) (n=84, 3.5%), or no hypertension (referent group; n=2258, 93.1%). Trajectories of 3D fetal measures were modeled using linear mixed effect models. Overall and weekly differences in trajectories, by HDP status, were tested, adjusting for covariates and multiple comparisons using Tukey’s method.
Compared to fetuses of normotensive women, fetuses of women with severe PE had smaller fractional lean arm volume at 15-17 weeks gestation and at 28-34 weeks (0.5-1.3 cm3). Fetuses of women who developed mild PE had larger maximum abdominal and thigh subcutaneous tissue thickness (SCTT) starting, on average, at 24 weeks and continuing through gestation, and larger cerebellar volume from 19-34 weeks gestation (0.3-4.5 cm3). Lastly, fetuses of women who developed GH had smaller fractional arm and thigh volumes (overall and lean) and abdominal area starting in the 2nd half of pregnancy, larger maximum abdominal SCTT starting at 29 weeks (0.3-0.6 mm), and larger cerebellar volume at 17-23 weeks.
Patterns of lean and fat tissue growth and cerebellar volume varied across HDP categories, often prior to clinical diagnosis. Future investigation is needed to determine whether these findings have clinically important implications for offspring cardiometabolic function and health.