Impaired fetal thymic growth precedes clinical preeclampsia: a case–control study

Eviston, David P.; Quinton, Ann; Benzie, R.; Peek, Michael; Martin, Andrew; Nanan, Ralph

doi:10.1016/j.jri.2012.04.001

Cited by 31 publications

(28 citation statements)

References 24 publications

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“…One retrospective case‐control study found that patients with preeclampsia had significantly smaller thymus measurements during the anatomic scan compared with matched controls 40 . To our knowledge, these findings have not been corroborated in a prospective fashion.…”

Section: Discussionmentioning

confidence: 79%

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Brandt

Bastek

Wang

et al. 2016

J of Ultrasound Medicine

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reterm birth, which is defined as delivery before 37 weeks' gestation, is responsible for 35% of deaths in the first year of life and more than $26 billion in annual health care costs. 1 Current methods for identifying women at increased risk for preterm birth are inadequate. Although universal cervical length screening during the second-trimester anatomic survey may identify patients at risk for spontaneous preterm birth, many patients with normal second-trimester cervical length measurements will still have preterm birth. [2][3][4] Justin S. Brandt, MD, Jamie A. Bastek, MD, MSCE, Eileen Wang, MD, Stephanie Purisch, MD, Nadav Schwartz, MD Received July 2, 2015, ORIGINAL RESEARCHObjectives-Previous studies have demonstrated an association between adverse obstetric outcomes, such as preterm birth, and in utero inflammation. The fetal thymus, which can be visualized in the anterior mediastinum on obstetric sonography, may involute in response to such inflammation and thus may identify pregnancies at increased risk for these outcomes. We therefore sought to determine whether secondtrimester fetal thymus measurements are associated with preterm birth.Methods-Transabdominal fetal thymus measurements were prospectively obtained in singleton pregnancies at gestational ages of 18 weeks to 23 weeks 6 days during a 5-month period. The transverse and anterorposterior thymus diameters and the thymicthoracic ratio were measured. Delivery outcomes were collected from our clinical database. The primary outcome was preterm birth, which we defined as delivery between 24 weeks and 36 weeks 6 days. Small for gestational age (SGA) and pregnancyrelated hypertension, which are adverse obstetric outcomes that may also be associated with in utero inflammation, were included as secondary outcomes.Results-We included 520 patients with thymus measurements and obstetric outcome data. The prevalence of preterm birth was 12.3% (n = 64). None of the thymus measurements were associated with preterm birth. Similarly, there was no association between thymus measurements and SGA or pregnancy-related hypertension.Conclusions-Sonographic assessment of the second-trimester fetal thymus did not identify patients at increased risk for preterm birth, SGA, and pregnancy-related hypertension. Routine thymus measurements during the second-trimester anatomic scan are not clinically useful for prediction of preterm birth and other adverse outcomes.

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Section: Discussionmentioning

confidence: 79%

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Brandt

Bastek

Wang

et al. 2016

J of Ultrasound Medicine

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“…Preeclampsia is the most extreme point of systemic inflammatory response and offers a good opportunity to assess the inflammatory process in pregnancy. Two recent studies have demonstrated that second trimester thymus size in preeclamptic pregnant women is smaller than in healthy controls [18,25]. The researchers claimed that preeclampsia triggers an acute-phase reaction in the fetus, leading to activation of the hypothalamo-pituitary-adrenal (HPA) axis and cortisol release.…”

Section: Discussionmentioning

confidence: 99%

“…The fetal thymus was imaged in transverse at the point of the upper mediastinum adjacent to the three large cardiac vessels. This image is relatively easy to obtain during the second trimester [18,25]. Obtaining a suitable transverse image is difficult in the third trimester.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency in pregnancy may affect fetal thymus development

Gür

Gur²,

İnce³

et al. 2016

Ginekol Pol

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Objectives: The aim of our study was to evaluate the association of vitamin D deficiency (VDD) during pregnancy with thymus size in full-term fetuses. Material and methods:In this prospective study, we evaluated mid-pregnancy serum 25-hydroxyvitamin Conclusions:Vitamin D deficiency during pregnancy may be associated with smaller fetal thymus. Our data suggest that VDD in pregnancy may lead to systemic inflammatory response in the fetus.

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“…According to previous studies, fetal thymic hypoplasia is associated with several conditions, such as fetal intrauterine growth restriction, chorioamnionitis associated with preterm premature rupture of membranes, and chromosomal abnormality, in particular, chromosome 22q11.2 deletion . In addition, fetal thymus growth is also reduced prior to the clinical onset of preeclampsia . Therefore, assessment of fetal thymus size may be helpful in some specific situations.…”

Section: Introductionmentioning

confidence: 99%

Sonographic measurement of fetal thymus size in uncomplicated singleton pregnancies

Tangshewinsirikul

Panburana

2016

J of Clinical Ultrasound

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Impaired fetal thymic growth precedes clinical preeclampsia: a case–control study

Cited by 31 publications

References 24 publications

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Second‐Trimester Sonographic Thymus Measurements Are Not Associated With Preterm Birth and Other Adverse Obstetric Outcomes

Vitamin D deficiency in pregnancy may affect fetal thymus development

Sonographic measurement of fetal thymus size in uncomplicated singleton pregnancies

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