Increased fetal epicardial fat thickness; a reflecting finding for GDM
and perinatal outcomes
Abstract
Objective: To study the value of fetal epicardial fat thickness
(EFT) in gestational diabetes mellitus in the third trimester of
pregnancy and its relationship with clinical parameters and perinatal
outcomes. Methods: A total of 80 participants, including 40
with diagnosed GDM and 40 healthy pregnant women, were included in the
study. Demographic data were obtained from medical records. Sonographic
examinations were performed, such as amniotic fluid value, fetal
biometric measurements, and Doppler parameters of the umbilical artery.
Fetal EFT values were measured at the free wall of the right ventricle
using a reference line with echocardiographic methods. Correlation tests
were performed to evaluate the relationship between fetal EFT and
clinical and perinatal parameters. P < 0.05 were interpreted
as statistically significant. Results: The fetal EFT value was
statistically higher in the GDM group than in the control group
(p:0.000). Spearman correlation tests revealed statistically significant
but weak positive correlations between fetal EFT value, 1-hour 100-gr
OGTT, birth weight, and BMI (r: 0.198, p:0.047; r:0.395, p:0.012;
r:0.360, p:0.042, respectively). The optimal fetal EFT threshold for
predicting GDM disease was found as 1.55 mm, with a specificity of
74.4% and sensitivity of 75.0%. Statistically significant differences
between the two groups in umbilical artery Doppler resistance index
(RI), pulsatility index (PI), and systolic/diastolic ratio (S/D) were
not found (p:0.337; p:0.503; p:0.155;). BMI and amniotic fluid volume
were higher in the GDM group compared to the control group (p:0.009;
p:0.000). Conclusion: This study demonstrated that increased
fetal EFT may occur as a reflection of changes in glucose metabolism in
intrauterine life. Future studies with larger series, including the
study of neonatal metabolic parameters, will contribute to the
understanding of the importance of fetal EFT in determining the
metabolic status of the fetus.