Growth patterns in fetuses with isolated cardiac defects

Objectives There is evidence that in fetuses with congenital heart defects (CHDs), head growth is affected. However, scanty data are available on longitudinal growth patterns of other biometric parameters such as abdominal circumference (AC) and femur length (FL). The aim was to evaluate growth patterns in fetuses with isolated CHD diagnosed prenatally in different categories of lesions. Methods Fetuses with isolated CHD seen between 2008 and 2013 at the Fetal Medicine Unit of 2 tertiary referral centers were retrospectively included in the study. CHD was classified into 7 categories. Fetal biometry parameters were assessed at 4 variable time points between 18 and 35 weeks' gestation and transformed into Z scores. Linear mixed modeling was performed to analyze repeated measurements and construction of growth models. Results Two hundred forty‐six live births with CHD were analyzed. Linear growth modeling showed a slight decrease in head circumference (HC) in the second half of pregnancy, whereas AC and FL growth were not significantly affected. The model predicted a significantly smaller HC at 36 weeks' gestation in fetuses with conotruncal heart defects. Conclusions Fetuses with CHD showed a modest but significant linear decrease in HC growth, whereas AC and FL growth trajectories remained stable. What's already known about this topic? Infants with congenital heart defects (CHDs) are reported to have a lower birthweight and smaller head circumference. Long‐term neurodevelopmental impairment is frequent in these children. What does this study add? Information on growth patterns of head circumference, abdominal circumference, and femur length in fetuses with CHD. Overall, fetal growth is not altered in CHD. Head circumference growth trajectory shows a modest but significant decrease with advancing gestation. Predicted head circumference at 36 weeks' gestation is significantly smaller in fetuses with conotruncal anomalies compared with control fetuses.