Background
Methods
Study
Fetal assessment
Postnatal assessment
Statistical analysis
Results
Cardiac changes in ART fetuses and infants
Characteristics | SC (n = 85) | ART (n = 88) | P |
---|---|---|---|
Maternal characteristics | |||
Age (years) | 33.0 (31.5, 36.0) | 34.0 (31.0, 36.0) | 0.793 |
BMI (kg/m2) | 26.11±3.44 | 25.74 (24.06, 28.29) | 0.500 |
Han, % (n) | 85.88 (73) | 86.36 (76) | 0.927 |
Nulliparity, % (n) | 56.47 (48) | 89.77 (79) | <0.001 |
Family cardiovascular history, % (n)a | 57.65 (49) | 48.86 (43) | 0.247 |
Low socioeconomic level, % (n) | 18.82 (16) | 28.41 (25) | 0.138 |
University education, % (n) | 87.06 (74) | 70.45 (62) | 0.008 |
Paternal characteristics | |||
Age (years) | 34.8±4.3 | 35.7±4.1 | 0.165 |
BMI (kg/m2) | 25.77±3.34 | 25.32±3.48 | 0.386 |
Han, % (n) | 88.24 (75) | 88.64 (78) | 0.934 |
Cigarette smoker, % (n) | 34.12 (29) | 43.18 (38) | 0.221 |
Family cardiovascular history, % (n)a | 57.65 (49) | 53.41 (47) | 0.575 |
Low socioeconomic level, % (n) | 5.88 (5) | 13.64 (12) | 0.087 |
University education, % (n) | 85.88 (73) | 70.45 (62) | 0.014 |
Fertility and ART characteristics | |||
Infertility cause, % (n) | |||
Unexplained | - | 12.50 (11) | - |
Female | - | 45.45 (40) | - |
Male | - | 18.18 (16) | - |
Female + male | - | 23.86 (21) | - |
ART technique, % (n) | |||
IVF | - | 54.55 (48) | - |
ICSI | - | 43.18 (38) | - |
IVF+ICSI | - | 2.27 (2) | - |
Transferred embryos, % (n) | |||
1 | - | 25.00 (22) | - |
2 | - | 73.86 (65) | - |
3 | - | 1.14 (1) | - |
FET, % (n) | - | 76.14 (67) | - |
Pregnancy complications, % (n) | |||
Preeclampsia | 4.71 (4) | 9.09 (8) | 0.256 |
Gestational diabetes | 23.53 (20) | 18.18 (16) | 0.386 |
Placenta previa | 2.35 (2) | 4.55 (4) | 0.710 |
Obstetric cholestasis | 0 (0) | 0 (0) | 1.000 |
Prenatal corticoid exposure | 1.18 (1) | 2.27 (2) | 1.000 |
Delivery data | |||
Gestational age at delivery (week) | 39.6±1.0 | 39.5±0.9 | 0.694 |
Cesarean section, % (n) | 48.24 (41) | 72.73 (64) | 0.001 |
Male, % (n) | 47.06 (40) | 52.27 (46) | 0.493 |
Birth length (cm) | 51.0 (49.5, 52.0) | 51.0 (50.0, 52.0) | 0.559 |
Birth weight (g) | 3380±280 | 3448±316 | 0.138 |
Neonatal outcome, % (n) | |||
Admission to NICU | 1.18 (1) | 0 (0) | 0.491 |
Major neonatal morbidityb | 0 (0) | 0 (0) | 1.000 |
Perinatal mortality | 0 (0) | 0 (0) | 1.000 |
Characteristics | SC (n = 85) | ART (n = 88) | P | Adjusted P* |
---|---|---|---|---|
Gestational age at scan (week) | 29.7 (28.7, 31.3) | 29.7 (29.0, 30.8) | 0.904 | - |
Estimated fetal weight (g) | 1460 (1265, 1733) | 1462 (1293, 1689) | 0.683 | - |
Placental data | ||||
Middle cerebral artery PI | 1.98±0.31 | 1.90±0.32 | 0.080 | 0.013 |
Umbilical artery PI | 1.04±0.17 | 1.03±0.16 | 0.565 | 0.736 |
Cerebroplacental ratio | 1.89 (1.71, 2.12) | 1.84 (1.62, 2.05) | 0.332 | 0.080 |
Aortic isthmus PI | 2.68±0.35 | 2.68±0.35 | 0.940 | 0.925 |
Ductus venosus PI | 0.54 (0.45, 0.69) | 0.55 (0.47, 0.73) | 0.591 | 0.629 |
Mean uterine artery PI | 0.85±0.21 | 0.74±0.20 | 0.001 | 0.010 |
Cardiac morphometry | ||||
Left atrial area (mm2) | 167.99±35.70 | 166.49±30.26 | 0.767 | 0.819 |
Right atrial area (mm2) | 173.73±31.48 | 175.14±32.53 | 0.772 | 0.608 |
LV area (mm2) | 244.25±47.13 | 262.33±45.96 | 0.011 | 0.002 |
RV area (mm2) | 221.14±42.60 | 236.10±38.63 | 0.016 | 0.003 |
LVSI mid | 2.45±0.39 | 2.29±0.34 | 0.003 | 0.006 |
LVSI base | 2.50±0.40 | 2.41±0.34 | 0.081 | 0.276 |
RVSI mid | 2.12 (1.97, 2.41) | 2.15±0.32 | 0.229 | 0.326 |
RVSI base | 2.11±0.28 | 2.16±0.26 | 0.229 | 0.187 |
Relative LV wall thickness | 0.36±0.05 | 0.35±0.04 | 0.035 | 0.074 |
Relative interventricular septal thickness | 0.37±0.06 | 0.36±0.05 | 0.134 | 0.347 |
Relative RV wall thickness | 0.34±0.05 | 0.34±0.05 | 0.715 | 0.833 |
Cardiothoracic ratio | 0.29 (0.27, 0.32) | 0.29±0.03 | 0.044 | 0.051 |
Systolic function | ||||
LVEF (%) | 63.43±5.22 | 63.46±4.43 | 0.963 | 0.435 |
RVEF (%) | 58.61±6.22 | 60.00 (55.95, 62.58) | 0.995 | 0.915 |
Left stroke volume (ml) | 2.46±0.71 | 2.25 (1.78, 3.06) | 0.923 | 0.991 |
Right stroke volume (ml) | 3.58 (3.01, 3.94) | 3.69±0.95 | 0.702 | 0.564 |
Left cardiac output (ml/min) | 352.25±97.65 | 328.69 (253.64, 419.31) | 0.639 | 0.727 |
Right cardiac output (ml/min) | 528.57 (446.15, 574.26) | 537.22±131.70 | 0.738 | 0.548 |
Mitral ring displacement (mm) | 6.75±1.81 | 5.69 (4.49, 7.79) | 0.025 | 0.111 |
Tricuspid ring displacement (mm) | 8.30±1.81 | 7.17 (6.25, 9.16) | 0.012 | 0.105 |
Mitral S′ (cm/s) | 5.74±0.82 | 5.80 (5.13, 6.29) | 0.645 | 0.760 |
Tricuspid S′ (cm/s) | 6.29 (5.71, 6.96) | 6.09 (5.71, 6.77) | 0.515 | 0.947 |
Diastolic function | ||||
Mitral E/A | 0.72±0.08 | 0.75±0.10 | 0.050 | 0.164 |
Tricuspid E/A | 0.73 (0.68, 0.79) | 0.73 (0.67, 0.80) | 0.891 | 0.668 |
Mitral E deceleration time (ms) | 40.00 (32.00, 48.00) | 44.00 (32.00, 54.00) | 0.548 | 0.362 |
Tricuspid E deceleration time (ms) | 28.00 (21.00, 36.00) | 29.00 (22.00, 39.50) | 0.784 | 0.806 |
Mitral E′ (cm/s) | 5.59±0.79 | 5.84±0.86 | 0.047 | 0.046 |
Mitral A′ (cm/s) | 8.35±1.69 | 8.19±1.64 | 0.521 | 0.334 |
Tricuspid E′ (cm/s) | 6.77 (5.61, 8.51) | 6.68 (5.90, 8.49) | 0.824 | 0.913 |
Tricuspid A′ (cm/s) | 11.04±1.81 | 10.88±2.42 | 0.627 | 0.652 |
Left isovolumic relaxation time (ms) | 48.16±9.44 | 45.89±8.57 | 0.098 | 0.138 |
Global cardiac function | ||||
Left myocardial performance index | 0.45±0.14 | 0.39 (0.31, 0.53) | 0.725 | 0.478 |
Right myocardial performance index | 0.38±0.12 | 0.38±0.16 | 0.988 | 0.707 |
Deformation analysis | ||||
Frame rate (fps) | 97.0 (92.0, 103.5) | 95.0 (89.3, 103.0) | 0.113 | - |
Heart rate (bpm) | 145.1±7.1 | 144.2±6.5 | 0.379 | 0.181 |
Systolic deformation | ||||
LV GLS (%) | −20.65±1.88 | −19.56±1.90 | <0.001 | 0.013 |
LV GLS rate S (s-1) | −3.58±0.39 | −3.32±0.36 | <0.001 | 0.023 |
LV global longitudinal T2P strain (ms) | 209.60±13.92 | 214.50±14.40 | 0.024 | 0.119 |
LV GCS (%) | −19.83±2.49 | −18.56 (−20.35, −17.20) | 0.031 | 0.260 |
LV GCS rate S (s-1) | −3.89±0.56 | −3.70±0.54 | 0.026 | 0.195 |
LV global circumferential T2P strain (ms) | 208.72±12.95 | 206.91±12.90 | 0.359 | 0.794 |
RV GLS (%) | −21.58±3.64 | −20.58±3.83 | 0.083 | 0.812 |
RV GLS rate S (s-1) | −3.41±0.76 | −3.25±0.82 | 0.210 | 0.906 |
RV global longitudinal T2P strain (ms) | 196.00 (185.00, 217.50) | 202.33±25.47 | 0.983 | 0.410 |
Diastolic deformation | ||||
LV GLS rate E (s-1) | 3.22±0.47 | 3.16±0.44 | 0.383 | 0.623 |
LV GLS rate A (s-1) | 3.85±0.57 | 3.63±0.52 | 0.010 | 0.100 |
LV GCS rate E (s-1) | 3.53±0.51 | 3.37 (2.93, 3.72) | 0.209 | 0.993 |
LV GCS rate A (s-1) | 3.46±0.67 | 3.17±0.59 | 0.004 | 0.165 |
RV GLS rate E (s-1) | 3.19±1.19 | 2.78 (2.08, 3.45) | 0.203 | 0.235 |
RV GLS rate A (s-1) | 3.60 (2.93, 4.30) | 3.78±1.32 | 0.899 | 0.936 |
Dyssynchrony | ||||
Longitudinal strain SDt18S (ms) | 26.41±6.59 | 27.28±6.45 | 0.380 | 0.321 |
Circumferential strain SDt18S (ms) | 22.75 (17.62, 27.74) | 24.13±6.97 | 0.595 | 0.493 |