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Am J Perinatol 2021; 38(07): 676-682
DOI: 10.1055/s-0039-3400308
Original Article

Antenatal Fetal Adrenal Measurements at 22 to 30 Weeks' Gestation, Fetal Growth Restriction, and Perinatal Morbidity

Nathan R. Blue 
1   Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
,
Matthew Hoffman 
2   Department of Obstetrics and Gynecology, Christiana Care Health System, Wilmington, Delaware
,
Amanda A. Allshouse
1   Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
,
William A. Grobman
3   Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
,
Hyagriv N. Simhan
4   Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania
,
Ozhan M. Turan
5   Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland
,
Samuel Parry
6   Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
,
Judith H. Chung
7   Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California
,
Uma Reddy
8   Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, Yale University, New Haven, Connecticut
,
David M. Haas
9   Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana
,
Stephen Myers
10   Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, Kansas
,
Brian Mercer
11   Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, Ohio
,
George R. Saade
12   Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Robert M. Silver
1   Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah
› Author Affiliations Funding This work was funded by the following NICHD grant awards: U10 HD063020, U10 HD063037, U10 HD063041, U10 HD063046, U10 HD063047, U10 HD063048, U10 HD063053, U10 HD063072, 1K12 HD085816.
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Abstract

Objective Our objective was to test the association of fetal adrenal size with perinatal morbidity among fetuses with fetal growth restriction (FGR; estimated fetal weight [EFW] < 10th percentile).

Study Design This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) adrenal study, which measured fetal adrenal gland size at 22 to 30 weeks' gestation. We analyzed the transverse adrenal area (TAA) and fetal zone area (absolute measurements and corrected for fetal size) and the ratio of the fetal zone area to the total transverse area using a composite perinatal outcome of stillbirth, neonatal intensive care unit admission, respiratory distress syndrome, necrotizing enterocolitis, retinopathy of prematurity, sepsis, mechanical ventilation, seizure, or death. Among fetuses with FGR, adrenal measurements were compared between those that did and did not experience the composite perinatal outcome.

Results There were 1,709 eligible neonates. Seven percent (n = 120) were diagnosed with FGR at the time of adrenal measurement, and 14.7% (n = 251) experienced perinatal morbidity. EFW-corrected and absolute adrenal measurements were similar among fetuses with and without FGR as well as among those who did and did not experience morbidity. The area under the curve for corrected TAA was 0.52 (95% confidence interval 0.38–0.67).

Conclusion In our cohort, adrenal size was not associated with risk of morbidity among fetuses with FGR.

Keywords

fetal growth restriction - perinatal morbidity - adrenal gland - placental insufficiency - prenatal ultrasound


Publication History

Received: 01 July 2019

Accepted: 30 September 2019

Article published online:
22 November 2019

© 2019. Thieme. All rights reserved.

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