{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T12:21:32Z","timestamp":1777033292312,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T00:00:00Z","timestamp":1609372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Echocardiographic studies have reported that fetuses with low birth weight, compared to those with normal birth weight, have globular hearts and reduced cardiac function. Dichotomizing continuous variables, such as birth weight, may be helpful in describing pathology in small studies but can prevent us from identifying physiological responses in relation to change in size. The aim of this study was to explore associations between fetal cardiac morphology and function and birth weight, as a continuous variable, as well as uterine artery (UtA) pulsatility index (PI), as an indirect measure of placental perfusion, and the cerebroplacental ratio (CPR), as an indirect measure of fetal oxygenation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective study of 1498 women with singleton pregnancy undergoing routine ultrasound examination at 35\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation. Pregnancies complicated by pregestational or gestational diabetes mellitus, chronic hypertension, pregnancy\u2010induced hypertension or pre\u2010eclampsia were excluded from the analysis. Conventional and more advanced echocardiographic modalities, such as speckle tracking, were used to assess fetal cardiac function in the right and left ventricles. The morphology of the fetal heart was assessed by calculating the right and left sphericity indices. In addition, the PI of the UtA, umbilical artery (UA) and fetal middle cerebral artery (MCA) was determined and the CPR was calculated by dividing MCA\u2010PI by UA\u2010PI. Multiple linear regression models were used to assess determinants of fetal echocardiographic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study population included 146 (9.7%) small\u2010for\u2010gestational\u2010age (SGA) fetuses with birth weight &lt;\u200910<jats:sup>th<\/jats:sup> percentile and 68 (4.5%) with fetal growth restriction (FGR). In the SGA and FGR groups, compared to the non\u2010SGA and non\u2010FGR fetuses, respectively, there was a more globular right ventricle and reduced left and right ventricular systolic function, and, from the left ventricular diastolic functional indices, the E\/A ratio was increased. There was a linear association of right ventricular sphericity index, indices of left and right ventricular systolic function and E\/A ratio with birth\u2010weight <jats:italic>Z<\/jats:italic>\u2010score. There were no significant associations between cardiac morphological and functional indices and UtA\u2010PI <jats:italic>Z<\/jats:italic>\u2010score or CPR <jats:italic>Z<\/jats:italic>\u2010score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This screening study at 35\u201337\u2009weeks' gestation has demonstrated that birth weight is a determinant of fetal cardiac morphology\nand function but UtA\u2010PI and CPR, as indirect measures of placental perfusion and fetal oxygenation, are not. This suggests that the differences in fetal cardiac indices between small and appropriately grown fetuses may be part of a normal physiological response to change in fetal size rather than part of a pathological adaptation to abnormal placental perfusion and fetal oxygenation. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23522","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T12:03:20Z","timestamp":1603454600000},"page":"266-272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Influence of birth weight on fetal cardiac indices at 35\u201337\u2009weeks' gestation"],"prefix":"10.1002","volume":"57","author":[{"given":"J.","family":"Semmler","sequence":"first","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Abdel\u2010Azim","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Anzoategui","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Zhang","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Charakida","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute King's College Hospital  London UK"},{"name":"School of Biomedical Engineering and Imaging Sciences King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,31]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.06.056"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.03.010"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.001490"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4537"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14930"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17365"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18820"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19193"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.07.025"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.06.008"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.12.031"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.10.889"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.10.890"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(00)00946-7"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20157"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90298-4"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19066"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15884"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20391"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12374"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1959"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2020.03.013"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu184"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.04.019"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000330792"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8870"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.12.012"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.01.023"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.297.6655.1026"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1990.tb02573.x"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70283-8"}],"container-title":["Ultrasound in Obstetrics &amp; 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