{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:05:44Z","timestamp":1785528344137,"version":"3.56.0"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNFSA170030576"],"award-info":[{"award-number":["NNFSA170030576"]}],"id":[{"id":"10.13039\/501100009708","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":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pre\u2010eclampsia (PE) and fetal growth restriction (FGR) have been shown to impact fetal cardiac remodeling in the third trimester and postnatally, with evidence to suggest that this leads to increased long\u2010term cardiovascular risk. This study aimed to examine fetal cardiac remodeling in pregnancies with PE and\/or FGR during the second trimester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a retrospective nationwide cohort study of ultrasound images from routine screening at 18\u201322\u2009weeks of gestation in Denmark. We included 139\u2009430 singleton pregnancies that were conceived spontaneously for which at least one relevant standardized cardiac plane (four\u2010chamber view and\/or three\u2010vessel view) was available from the second\u2010trimester scan. An artificial intelligence model performed automated segmentation and extraction of fetal cardiac biometric measurements. Data were collected for four groups: the reference group, defined as appropriate\u2010for\u2010gestational\u2010age (AGA) fetuses from a normotensive pregnancy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009131\u2009150); AGA fetuses from a PE pregnancy (AGA + PE group;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093095); FGR fetuses from a normotensive pregnancy (normotensive + FGR group;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094572); and FGR fetuses from a PE pregnancy (PE + FGR group;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009613). Differences between groups in cardiac biometric measurements were presented as\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010scores adjusted for abdominal circumference at the second\u2010trimester scan.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with the reference group, fetuses in the PE\u2009+\u2009AGA group had significantly larger right\u2010sided heart structures, and the main pulmonary artery (MPA) and ventricular septum were wider. Fetuses in the normotensive\u2009+\u2009FGR group displayed significantly smaller cardiac structures, including smaller MPA and ascending aorta diameters, and increased left ventricular sphericity compared with the reference group. Fetuses in the PE\u2009+\u2009FGR group differed significantly from the reference group only in terms of smaller left atrial area, narrower ascending aorta and increased left ventricular sphericity. However, PE\u2009+\u2009FGR fetuses had significantly wider MPA and\u00a0ventricular septum\u00a0and larger right\u2010sided structures compared with normotensive\u2009+\u2009FGR fetuses, mimicking the features of the PE\u2009+\u2009AGA group, suggesting a distinct effect of PE on fetal cardiac remodeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Cardiac remodeling is evident as early as the second trimester, with distinct patterns of modulation in fetuses from pregnancies affected by PE\n                      <jats:italic>vs<\/jats:italic>\n                      FGR. In particular, PE is associated with an enlarged right heart and greater MPA diameter. Understanding these early differences in fetal cardiac morphology may improve risk prediction models and guide early intervention to improve long\u2010term cardiovascular outcome. \u00a9 2025 The Author(s).\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.70123","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T10:01:40Z","timestamp":1761818500000},"page":"510-518","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Fetal cardiac remodeling in second trimester in pregnancies with pre\u2010eclampsia and\/or fetal growth restriction: deep\u2010learning\u2010based approach using population\u2010wide data"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5634-2830","authenticated-orcid":false,"given":"C. A.","family":"Taks\u00f8e\u2010Vester","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Gynecology, Fertility and Obstetrics, Center of Fetal Medicine Copenhagen University Hospital  Rigshospitalet, Copenhagen Denmark"},{"name":"Copenhagen Academy of Medical Education and Simulation, Rigshospitalet  Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Mikolaj","sequence":"additional","affiliation":[{"name":"DTU Compute Technical University of Denmark  Lyngby Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8517-4082","authenticated-orcid":false,"given":"O. B.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Gynecology, Fertility and Obstetrics, Center of Fetal Medicine Copenhagen University Hospital  Rigshospitalet, Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. K.","family":"Ekelund","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Gynecology, Fertility and Obstetrics, Center of Fetal Medicine Copenhagen University Hospital  Rigshospitalet, Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. G.","family":"Vejlstrup","sequence":"additional","affiliation":[{"name":"Department of Cardiology Copenhagen University Hospital  Rigshospitalet, Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Vedel","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fertility and Obstetrics, Center of Fetal Medicine Copenhagen University Hospital  Rigshospitalet, Copenhagen Denmark"},{"name":"Department of Clinical Genetics Copenhagen University Hospital  Rigshospitalet, Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. N.","family":"Christensen","sequence":"additional","affiliation":[{"name":"DTU Compute Technical University of Denmark  Lyngby Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Feragen","sequence":"additional","affiliation":[{"name":"DTU Compute Technical University of Denmark  Lyngby Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Computer Science University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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