Supplementary Material for: Changes in Fetal Circulation Associated with Congenital Heart Disease and Their Effects on Fetal Growth

Objective: Our aim was to investigate the association between fetal growth and cerebrovascular resistance in fetuses with congenital heart disease (CHD). Methods: Fetal echocardiography was performed to measure the biparietal diameter, abdominal circumference, femur length, estimated fetal body weight, middle cerebral artery (MCA) resistance index (RI) and umbilical artery (UA) RI in 44 fetuses with CHD and 140 normal fetuses at a gestational age of 28–34 weeks. Results: Fetuses with CHD exhibited significantly lower values for femur length, estimated fetal body weight at the third trimester, body weight, length, and chest circumference at birth than normal controls. The percentages of fetuses showing MCA RI values <10th percentile and UA RI values >90th percentile were significantly higher in the CHD group than in the control group. However, there were no significant differences in any biometric parameters measured between cases with MCA RI values ≧10th percentile and values <10th percentile. Conclusions: Growth restriction and blood flow changes were observed significantly more frequently in fetuses with CHD than in those without CHD. Further studies are necessary to clarify the association between fetal growth and dynamic changes in fetal circulation.

研究目的：本研究旨在探讨先天性心脏病（CHD）胎儿的胎儿生长情况与脑血管阻力之间的关联。研究方法：于妊娠28~34周时，对44例先天性心脏病（CHD）胎儿与140例正常胎儿开展胎儿超声心动图检查，测量其双顶径、腹围、股骨长、估算胎儿体重、大脑中动脉（MCA）阻力指数（RI）及脐动脉（UA）阻力指数（RI）。研究结果：与正常对照组相比，先天性心脏病胎儿的股骨长、妊娠晚期估算胎儿体重、出生体重、身长及出生胸围均显著低于对照组。先天性心脏病组中，大脑中动脉阻力指数<第10百分位与脐动脉阻力指数>第90百分位的胎儿占比均显著高于对照组。然而，在大脑中动脉阻力指数≥第10百分位与<第10百分位的病例之间，各项测量的生物学参数均无显著差异。研究结论：相较于无先天性心脏病的胎儿，先天性心脏病胎儿出现生长受限及血流改变的比例显著更高。未来需开展进一步研究以阐明胎儿生长与胎儿循环动态变化之间的关联。