Premium
Prognostic Value of Fetal Thymus Size in Intrauterine Growth Restriction
Author(s) -
Ekin Atalay,
Gezer Cenk,
Taner Cuneyt Eftal,
Solmaz Ulas,
Gezer Naciye Sinem,
Ozeren Mehmet
Publication year - 2016
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.15.05039
Subject(s) - medicine , intrauterine growth restriction , fetal growth , value (mathematics) , fetus , obstetrics , pregnancy , gynecology , statistics , mathematics , genetics , biology
Objectives Our aim was to evaluate the size of the fetal thymus by sonography in pregnancies with intrauterine growth restriction (IUGR) and to search for a possible relationship between a small fetal thymus and adverse perinatal outcomes. Methods The transverse diameter of the fetal thymus was prospectively measured in 150 healthy and 143 IUGR fetuses between 24 and 40 weeks' gestation. The fetuses with IUGR were further divided according to normal or abnormal Doppler assessment of the umbilical and middle cerebral arteries and ductus venosus. Measurements were compared with reference ranges from controls. To determine which perinatal outcomes were independently associated with a small fetal thymus, a multivariate logistic regression analysis was performed. Results Thymus size was significantly lower in IUGR fetuses compared to controls ( P < .05). Among IUGR fetuses, thymus size was significantly smaller in IUGR fetuses with abnormal Doppler flow compared to normal flow ( P < .05). A small thymus in IUGR fetuses was independently associated with early delivery (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.05–1.49; P = .023), respiratory distress syndrome (OR, 1.36; 95% CI, 1.09–1.78; P = .005), early neonatal sepsis (OR, 1.65; 95% CI, 1.11–2.42; P = .001), and a longer stay in the neonatal intensive care unit (OR, 1.33; 95% CI, 1.08–1.71; P = .017). Conclusions Intrauterine growth restriction is associated with fetal thymic involution, and a small fetal thymus is an early indicator of adverse perinatal outcomes in pregnancies complicated by IUGR.