{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T06:11:09Z","timestamp":1759471869943,"version":"build-2065373602"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This research aimed to observe the pregnancy outcomes and early infancy physical growth of fetuses with situs inversus detected during the coronavirus disease 2019 (COVID-19) pandemic at two centers in South China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected from pregnant women with fetal situs inversus between March 2023 and May 2024. Systemic structured ultrasound, clinical manifestations, and genetic tests were conducted. Data on pregnancy outcomes and routine physical examinations of neonates and infants were collected. Statistical analysis was performed to compare the incidence rate of fetal situs inversus in 2023 with the median incidence rate in previous years. Z-scores for head circumference, weight, and length of the infants were calculated using PediTools Electronic Growth Chart Calculators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 27 patients with fetal situs inversus were detected; situs inversus with dextrocardia was the most common category of all cases (23\/27, 85.2%). The incidence rate of fetal situs inversus in Center 1 increased more than sixfold in 2023 compared with the median incidence rate of previous years (1.75\u2030 vs. 0.25\u2030, <jats:italic>p<\/jats:italic>\u202f=\u202f0.000), while in Center 2, the increase was not so obvious (1.22\u2030 vs. 0.51\u2030, <jats:italic>p<\/jats:italic>\u202f=\u202f0.011), both with the peak number of affected fetuses detected mainly in April 2023. In total, 15 newborns with situs inversus totalis (SIT) were delivered (15\/27, 55.6%), and the majority were alive and reached their normal growth milestones, except for one infant death. Overall, 11 pregnancies underwent therapeutic abortion, and 1 pregnant woman received twin reduction surgery for one of the cotwins (12\/27, 44.4%). Z-score evaluation showed no abnormal early physical growth in weight, head circumference, or length among infants with SIT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A high incidence of fetal situs inversus during the COVID-19 pandemic was observed in our study. Situs inversus with dextrocardia was associated with relatively good pregnancy outcomes in non-complicated cases. No abnormal early infancy physical growth in weight, head circumference, or length was observed among infants with SIT.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1581322","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T05:30:57Z","timestamp":1759469457000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pregnancy outcomes and early infancy physical growth of fetal situs inversus during the COVID-19 pandemic"],"prefix":"10.3389","volume":"12","author":[{"given":"Yongke","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingsheng","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haijun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fenge","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2437","DOI":"10.2147\/IJGM.S295444","article-title":"Situs 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Gynecol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2478\/aite-2024-0001","article-title":"Mechanisms of SARS-CoV-2 placental transmission","volume":"72","author":"Gostomczyk","year":"2023","journal-title":"Arch Immunol Ther Exp"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"C723","DOI":"10.1152\/ajpcell.00169.2021","article-title":"The atlas of ACE2 expression in fetal and adult human hearts reveals the potential mechanism of heart-injured patients infected with SARS-CoV-2","volume":"4","author":"Hao","year":"2022","journal-title":"Am J Physiol Cell Physiol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e2424","DOI":"10.1002\/bdr2.2424","article-title":"Observed prevalence of congenital situs inversus in the United States before and during the SARS-CoV-2 pandemic, 2017-2022","volume":"116","author":"Cragan","year":"2024","journal-title":"Birth Defects 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