Epicardial Fat Thickness in Fetal Growth Restriction: Impact on Neonatal Outcomes and Predictive Value

PURPOSE: Fetal growth restriction (FGR) is a condition associated with heightened risks of perinatal morbidity and mortality. Epicardial adipose tissue (EAT) has been identified as a potential marker for metabolic changes in fetuses, but its role in FGR remains underexplored. This study aimed to assess fetal epicardial fat thickness (EFT) in the third trimester and its correlation with FGR diagnosis and fetal measurements. METHOD: A cross-sectional analytical study was conducted at a Perinatology Clinic involving 82 pregnant women, including 43 with FGR and 39 controls. FGR diagnosis was based on Delphi criteria. EFT measurements were performed using echocardiography techniques, and statistical analyses were conducted to assess correlations and predictive values. Fetal EFT was measured using ultrasound, and interobserver reliability was assessed using the Intraclass Correlation Coefficient (ICC). RESULTS: In the FGR group, EFT was significantly lower than in controls (p < 0.001). A significant moderate positive correlation was observed between EFT and fetal abdominal circumference (r = 0.363, p = 0.017). ROC analysis identified an EFT cutoff value of ≤ 1.41 mm for discriminating FGR, with 60.5% sensitivity and 92.3% specificity (AUC = 0.802, p < 0.001). In addition, EFT showed significant discriminatory ability for composite adverse neonatal outcomes (AUC = 0.727, p = 0.001). CONCLUSION: This study highlights the potential clinical significance of fetal EFT thickness in FGR diagnosis and neonatal outcome prediction. EFT measurements offer valuable insights into fetal metabolic status and may aid in early identification of high-risk pregnancies. Further research is warranted to validate these findings and integrate EFT assessments into routine prenatal care for improved perinatal management strategies.