The Role of Fetal Epicardial Fat Thickness and Truncus Pulmonalis Diameter in Prediction of Perinatal Outcomes in Diabetic Pregnancies

Background: Maternal diabetes continues to be a global health concern, with long-term effects on offspring that include metabolic syndrome, obesity, and cardiovascular illness, in addition to immediate neonatal morbidity. Finding early indicators of cardiometabolic risk in babies exposed to maternal diabetes mellitus, such as fetal epicardial fat thickness (fEFT) and main pulmonary artery diameter (MPAD), has become more popular as a result.
Objective: To investigate the relationship between the major pulmonary artery diameter and the thickness of the fetal epicardial fat and the perinatal outcomes in pregnancies with and without diabetes.
Patients and Methods: 81 pregnant females who were admitted to Menoufia University's Obstetrics and Gynecology Department between August 2022 and November 2024 were the subjects of this case-control study, which involved three case cohorts; 27 healthy, non-diabetic females made up Cohort A; 27 females with gestational DM were in Cohort B; and 27 females with pre-gestational (preexisting) diabetes mellitus, including type 1 and type 2, were in Cohort C.
Results: While main pulmonary artery diameter lacks the sensitivity and specificity of fEFT, did not differ significantly across cohorts, and only demonstrated a weak predictive ability for neonatal respiratory distress or NICU admission, our findings show that fEFT is significantly increased in fetuses of diabetic mothers (in pregestational DM more than gestational DM), and is clearly correlated with adverse neonatal outcomes.
Conclusion: According to our research, adding fEFT measurement to third-trimester ultrasound evaluations may help identify fetuses at risk in diabetes pregnancies early on, enabling improved surveillance and focused perinatal care.