Implications of familial Mediterranean fever on the fetal adrenal gland: a case-control study Running title: Familial Mediterranean fever and fetal adrenal gland

Abstract

Objective: To investigate fetal adrenal dimensions in pregnant women diagnosed with familial Mediterranean fever (FMF) and healthy pregnant women. Materials and Methods: This study was conducted with 36 women diagnosed with FMF and 72 healthy pregnant women who were followed up and delivered in the perinatology clinic. Fetal adrenal dimensions were evaluated ultrasonographically in axial, sagittal, and coronal sections between the 340/7 and 370/7 weeks of gestation. Height, depth, and width were measured in the total adrenal length (TAL), width (TAW), height (TAH), and fetal zone adrenal length (FAL), width (FAW), height (FAH), and the volume (TAV and FAV) were calculated. Participants' birth week, birth weight, and Apgar scores were recorded. The case group was divided into colchicine users and those who did not require colchicine use during pregnancy. Results: The sociodemographic and obstetric characteristics of the participants were similar. TAH, TAV, FAL, and FAV were significantly larger in the FMF group (p<0.001). The mean value of the FAV/TAV was 0.15 cm3 in the FMF group and 0.14 cm3 in the control group. Although the mean value of the volume ratio was increased in the FMF group, there was no statistically significant difference between them (p=0.505). TAH was found to be significantly increased in the group not using colchicine (p=0.014). Conclusion: This is the first study conducted on the fetal adrenal gland in pregnant women diagnosed with FMF. Exposure to intrauterine stress due to chronic inflammation might result in increased fetal adrenal gland sizes.