Investigation of pancreatic size and clinical effects in cases with late-onset fetal growth restriction

The aim of our study was to evaluate fetal pancreas size in cases of isolated late-onset fetal growth restriction (FGR) and to assess its relationship with clinical and laboratory findings in the early neonatal period. Pregnant individuals diagnosed with late-onset FGR according to Delphi consensus criteria formed the study group, while healthy pregnant women matched for gestational age formed the control group. Fetal pancreatic circumference and corresponding percentile value and fetal abdominal circumference to pancreas circumference (FACPC) ratio measurements were obtained. Neonatal blood sugar levels, admission to the neonatal intensive care unit (NICU), and other metabolic parameters were recorded. A total of 154 pregnant individuals, including 67 FGR and 87 healthy control groups, were included in our study. The pancreatic circumference and pancreatic circumference percentile were significantly lower in the FGR group (p < 0.001). There was no significant difference between the two groups in terms of FACPC ratio (p = 0.74). A statistically significant positive correlation was observed between the FACPC ratio and neonatal blood glucose levels (r = 0.298, p = 0.01). However, no significant correlation was observed between fetal pancreas size and short-term clinical and laboratory neonatal outcomes such as hypoglycemia or admission to the neonatal intensive care unit. In our ultrasound-based imaging study, we quantitatively assessed fetal pancreas size in cases of late-onset FGR. Pancreatic size was significantly lower in the FGR group. There was a significant positive correlation between FACPC ratio and neonatal blood glucose levels. The results of this study provide preliminary evidence of the possible effects of fetal pancreatic development on fetal growth and perinatal metabolic regulation. In clinical practice, fetal pancreatic biometry could be considered as an adjunct parameter during ultrasound evaluations of FGR cases.