Supplementary Material for: Use of the Myocardial Performance Index in Decreased Fetal Movement Assessment: A Case-Control Study

<b><i>Objectives:</i></b> To determine whether there are any fetal cardiac function changes, as measured by the myocardial performance index (MPI), in pregnancies complicated by decreased fetal movement (DFM). <b><i>Methods:</i></b> We performed a prospective cross-sectional case-control study of 50 DFM and 50 uncomplicated third-trimester pregnancies matched within 2 gestational weeks. Routine ultrasound growth and well-being parameters as well as MPI were measured. Average MPI measurements and its component values were compared between the DFM and the control group, as were demographics, other ultrasound data, and perinatal outcomes. <b><i>Results:</i></b> Average left MPI (LMPI) and right MPI (RMPI) was similar between groups (LMPI: 0.54 ± 0.08 [DFM], 0.53 ± 0.08 [controls], <i>p</i> = 0.76; RMPI: 0.60 ± 0.12 (DFM), 0.59 ± 0.11 [controls], <i>p</i> = 0.79). However, subgroup analysis of DFM fetuses with (<i>n</i> = 20) or without (<i>n</i> = 30) any adverse perinatal outcome demonstrated modestly higher average RMPI and LMPI in the adverse perinatal outcome group (RMPI: 0.64 ± 0.08 vs. 0.57 ± 0.13, <i>p</i> = 0.02; LMPI: 0.56 ± 0.07 vs. 0.52 ± 0.07, <i>p</i> = 0.052). <b><i>Conclusion:</i></b> The MPI did not demonstrate clinically usable differences between the overall DFM population and controls. However, higher LMPI and RMPI values in the exploratory subgroup of DFM fetuses with adverse perinatal outcomes may warrant further exploration of the MPI in DFM.

**研究目的：** 旨在探究合并胎儿运动减少（decreased fetal movement, DFM）的妊娠中，以心肌性能指数（myocardial performance index, MPI）评估的胎儿心功能是否存在异常变化。
**研究方法：** 本研究为前瞻性横断面病例对照研究，纳入50例DFM妊娠孕妇与50例孕周匹配（相差不超过2个孕周）的无合并症妊娠晚期孕妇作为对照。对所有研究对象测定常规超声生长发育、胎儿健康状况参数及心肌性能指数（MPI）。对比两组的平均MPI值及其组分参数、人口学特征、其他超声指标及围产期结局。
**研究结果：** 两组的左心室心肌性能指数（left myocardial performance index, LMPI）与右心室心肌性能指数（right myocardial performance index, RMPI）均值无显著统计学差异（LMPI：DFM组0.54±0.08，对照组0.53±0.08，*p*=0.76；RMPI：DFM组0.60±0.12，对照组0.59±0.11，*p*=0.79）。不过，针对DFM胎儿中发生（*n*=20）与未发生（*n*=30）不良围产期结局的亚组进行分析后发现，发生不良围产期结局的亚组其平均RMPI与LMPI水平略高（RMPI：0.64±0.08 vs 0.57±0.13，*p*=0.02；LMPI：0.56±0.07 vs 0.52±0.07，*p*=0.052）。
**研究结论：** 整体而言，DFM妊娠人群与对照组的MPI值未表现出具有临床应用价值的差异。但合并不良围产期结局的DFM胎儿亚组其LMPI与RMPI水平升高，提示MPI在DFM中的应用价值值得进一步探索。