The goal of this observational study is to learn about cardiac function and remodelling and metabolomic profiles in fetuses and infants who were exposed to a threatened preterm labor (TPL) during pregnancy.
The main questions it aims to answer are: * Evaluate the impact of threated preterm labour in cardiovascular and metabolic programming in fetal life and early infancy. * Describe prenatal and postnatal patterns of cardiac remodelling associated to threatened preterm labour. * Describe fetal growth patterns associated to threatened preterm labour. * Describe metabolomic profiles in umbilical cord blood associated to cardiovascular programming in fetuses exposed to threatened preterm labour. The study's main tasks are: * To perform an antenatal echocardiography of the exposed cohort is performed during the admission due to TPL or preterm spontaneous rupture of membranes (SRM). * All participants are asked to fill a diet and stress questionnaire. * To collect cord blood at the time of delivery. * To perform a postnatal echocardiography six months after birth. Researchers will compare fetuses and infants who were exposed to TPL to those who were not exposed to TPL during pregnancy to see if threre are any differences in cardiac function and remodelling.
Study Type
OBSERVATIONAL
Enrollment
200
Presence of uterine contractions and cervical shortening between 24+0 and 36+6 weeks of gestation and/or rupture of the membranes between 24+0 and 36+6 weeks of gestation.
Hospital Clinico Universitario Lozano Blesa
Zaragoza, Spain
RECRUITINGFetal cardiac sphericity index
2-D mode
Time frame: 24 - 36+6 weeks of gestation
Fetal cardiac diameters
Measurement of atrial and ventricular longitudinal and transverse diameters with 2-D mode
Time frame: 24 - 36+6 weeks of gestation
Fetal ventricular and atrial areas
2-D mode
Time frame: 24 - 36+6 weeks of gestation
Fetal cardiac ejection fraction
Pulsed-Doppler
Time frame: 24 - 36+6 weeks of gestation
Fetal cardiac ejection volume
Pulsed-Doppler
Time frame: 24 - 36+6 weeks of gestation
Fetal cardiac filling and ejection time fractions
Pulsed-Doppler
Time frame: 24 - 36+6 weeks of gestation
Fetal cardiac debit
Pulsed-Doppler
Time frame: 24 - 36+6 weeks of gestation
Fetal mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE)
M-mode
Time frame: 24 - 36+6 weeks of gestation
Fetal cardiac E/A ratios
Pulsed-Doppler
Time frame: 24 - 36+6 weeks of gestation
Fetal cardiac isovolumetric relaxation time
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Pulsed-Doppler
Time frame: 24 - 36+6 weeks of gestation
Fetal Doppler
Measurement of umbilical artery pulsatility index (PI), medial cerebral artery PI and systolic peak (SP), ductus venosus PI, and mean uterine arteries PI using pulsed-Doppler
Time frame: 24 - 36+6 weeks of gestation
Fetal growth
Hadlock formula
Time frame: 24 - 36+6 weeks of gestation
ProBNP, troponin and cystatin levels in cord blood
Electrochemiluminescence immunoassay
Time frame: Third stage of labor
Estimated left ventricular myocardial mass
2D echochardiography
Time frame: 6 months
Left ventricular muscle index
2D echochardiography
Time frame: 6 months
Left ventricular end-diastolic volume
2D echochardiography
Time frame: 6 months
Left ventricular ejection fraction
2D echochardiography
Time frame: 6 months
Infant global cardiac longitudinal strain rate
Using echocardiography in order to measure myocardial function
Time frame: 6 months
Infant cardiac strain rate imaging
Using echocardiography in order to measure myocardial function
Time frame: 6 months
Adherence to Mediterranean diet
Validated 14-item PREDIMED (Prevención con dieta mediterránea) questionnaire. Minimum value is 0. Maximum value is 14. We expect a better outcome the higher the score.
Time frame: 24 - 36+6 weeks of gestation
Maternal stress levels
Perceived Stress Scale (PSS). Minimum score: 0. Maximum score: 40. We expect to find worse outcomes with higher scores.
Time frame: 24 - 36+6 weeks of gestation
Maternal anxiety levels
State-Trait Anxiety Index (STAI). Minimum score: 20. Maximum score: 80. We expecto to find worse outcomes with higher scores.
Time frame: 24 - 36+6 weeks of gestation