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Epidemiology

Poster Session 4

(1173) Three-dimensional fetal body composition and organ volume growth patterns in hypertensive disorders of pregnancy

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Hypertensive disorders of pregnancy (HDP) complicate 5-8% of pregnancies and are associated with lower birthweight and fetal growth restriction. No studies have evaluated the association between HDP and three-dimensional (3D) measures of fetal body composition, such as lean and fat tissue, and organ volumes across pregnancy. Differential accumulation of fetal lean and fat tissue, or organ volume growth, may be a more sensitive marker for abnormal fetal growth.

Study Design:

In the NICHD Fetal 3D Study (n=2430 pregnancies), fetal body composition and organ volumes were measured at up to five 3D ultrasounds between 15 to 40 weeks by certified sonographers per protocol. Women were identified as having severe preeclampsia (PE) (n=32, 1.3%), mild PE (n=52, 2.1%), gestational hypertension (GH) (n=84, 3.5%), or no hypertension (referent; n=2262, 93.1%). Trajectories of 3D fetal measures were modeled using linear mixed effect models. Overall and weekly mean differences in the trajectories, by hypertensive status, were tested after adjustment for covariates.

Results:

Compared to pregnancies without hypertension, fetuses of women who developed severe PE had smaller fractional lean arm and thigh volumes starting at 15 and 18 weeks, respectively, prior to PE diagnosis and continuing through term, reaching statistical significance at 15-17 and 28-34 weeks for arm and 27 weeks for thigh (Table). Fetuses of women who developed mild PE had larger maximum abdominal and thigh SCTT starting, on average, at 23 weeks through term, and larger cerebellar volume starting at 19 weeks (Table). 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, and larger cerebellar volume at 17-23 weeks (Table).

Conclusion:

Patterns of lean and fat tissue growth and cerebellar volume varied across HDP categories. Future investigation is needed to determine whether these findings have clinically important implications for offspring cardiometabolic function and health.