A prospective investigation of the relationship between fetal pancreas size and gestational age in large for gestational age fetuses

ABSTRACT Objective: This study aimed to evaluate the relationship between fetal pancreatic size and fetal growth status in pregnancies without a diagnosis of pregestational or gestational diabetes, by comparing fetuses that are large for gestational age with those appropriate for gestational age. The primary objective was to investigate the utility of fetal pancreatic measurements in the prenatal prediction of fetuses and to contribute to a better understanding of fetal growth patterns. Study Setting: Department of Obstetrics and Gynecology, Selcuk University. Materials and Methods: This prospective observational study was conducted on singleton pregnancies between 28 and 40 weeks of gestation in women aged 18–40 years. Fetuses with an estimated fetal weight above the 90th percentile for gestational age were classified as the large for gestational age group, while those between the 10th and 90th percentiles were included as the control group. All fetal pancreatic measurements were performed via ultrasonography. Results: Fetal pancreatic length, width, and area were found to be significantly higher in the large for gestational age group compared to the control group. A linear increase in pancreatic size was observed with advancing gestational age, which was more pronounced in the large for gestational age group. The pancreatic width-to-abdominal circumference (AC) ratio was significantly higher in the large for gestational age group compared to the control group (p = 0.004). The pancreatic width-to-AC ratio showed a marginal difference between groups (p = 0.064), but regression analysis according to gestational age revealed a statistically significant association (p = 0.042). According to the regression model, when controlling for gestational age, the pancreatic length-to-AC ratio was on average 0.0063 units higher and the pancreatic width-to-AC ratio was 0.0027 units higher in the large for gestational age group compared to the control group. Conclusion: The findings indicate that fetal pancreatic size increases with gestational age, and this increase is more pronounced in large for gestational age fetuses. These results suggest that ultrasonographic evaluation of the fetal pancreas may be a useful tool in the prenatal prediction of large for gestational age fetuses. This method may have clinical value for assessing fetal metabolic status and for the early detection of potential perinatal risks. Keywords: Fetal pancreas, large for gestational age, macrosomia, pregnancy, ultrasonography, fetal biometry