(155) Influence of intra-amniotic infection and inflammation on the fetal cardiac structure.

Objective: To assess the influence of intra-amniotic infection and/or inflammation (IAI) on the fetal cardiac structure.

Study Design: Prospective cohort study (2018-2021) conducted in Hospital Clinic and Hospital Sant Joan de Déu (BCNatal, Barcelona)  including singleton pregnancies.
The exposed group included women with preterm labor (PTL) and/or preterm prelabor rupture of membranes (PPROM) with IAI (positive amniotic fluid culture and/or high levels of IL6) (group A) and without IAI (group B). The non-exposed group included women without PTL/PPROM (group C).
Fetal cardiac parameters were evaluated by 2D ultrasound in end-diastole within the first 72h after admission and, in non-exposed women, at a similar gestational age. Results were adjusted for estimated fetal weight up to 10th centile and, in the exposed group, also for the occurrence of PTL or PPROM. Patterns of ventricular hypertrophy were assessed by relative wall thickness using M-Mode.

Results: For the overall population, 41 had IAI (28/41 were PPROM), 54 had symptoms of PTL/PPROM without IAI (6/54 were PPROM), and 48 were non-exposed women (without symptoms of PTL/PPROM). There were no significant differences in maternal characteristics (including maternal age, BMI, ethnicity, smoking habit, prevalence of hypertension, pregestational diabetes or artificial reproduction techniques and parity), fetal sex or gestational age at ultrasound between groups. There were more fetuses with estimated fetal weight under 10th centile in the IAI group. Cardiac size were similar between groups. Fetus with IAI had a global concentric myocardial hypertrophy and fetus without IAI only presented a left concentric hypertrophy when compared to the non-exposed group.

Conclusion: Women exposed to PTL/PPROM presented a concentric myocardial hypertrophy more pronounced in the IAI group when compared to the non-exposed group.