Pregnancy Complications in Fetal Congenital Heart Disease: A Result of Common Early Developmental Pathways Rather Than Fetal Hemodynamics.

IF 2.7 2区医学 Q2 GENETICS & HEREDITY

Prenatal Diagnosis Pub Date : 2025-05-26 DOI:10.1002/pd.6819

Maartje C Snoep, Damla Demir, Anouk M C Roestenburg, Eva Pajkrt, Elisabeth van Leeuwen, Ingeborg H Linskens, Ingmar Knobbe, Sally-Ann Clur, Lieke Rozendaal, Lotte E van der Meeren, Monique C Haak

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引用次数: 0

Abstract

Objective: The aim of this study was to compare placenta-related complications (adverse placental syndrome) between different types of fetal CHD based on cardiac hemodynamics.

Method: All CHD cases diagnosed prenatally by fetal ECHO during 2009-2023 were selected. Exclusion criteria were as follows: multiple pregnancies, pregnancy termination, known genetic aberrations, and extracardiac anomalies. Cases were categorized into 6 groups based on theorized hemodynamic factors. Reference values for fetal growth restriction (FGR), preeclampsia (PE), pregnancy induced hypertension (PIH), and intra uterine fetal demise (IUFD) from the overall Dutch and/or European population were used.

Results: After exclusion, 1293 cases were available for analysis. The incidence of FGR was 198/1247 (15.9%). There was a significant difference in FGR between the groups of CHD (p = 0.002) though it could not be correlated with aortic flow and oxygenation. There was a high incidence of PE (64/1282, 5.0%), PIH (43/1284, 3.3%), and IUFD (33/1291, 2.6%) in our cohort as compared to reference values. Nonetheless, there were no differences in PE, PIH, and IUFD between the different CHD groups.

Conclusion: A high incidence of adverse placental syndrome was found though this could not be related to fetal hemodynamics. Even in CHDs without hemodynamic changes, a high incidence of these complications was found. This might be a clinical manifestation of early embryological developmental pathways that affect both the placenta and the fetal heart.

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胎儿先天性心脏病的妊娠并发症：常见的早期发育途径而不是胎儿血流动力学的结果。

目的：本研究的目的是基于心脏血流动力学比较不同类型胎儿冠心病的胎盘相关并发症（不良胎盘综合征）。方法：选取2009-2023年间所有经胎儿ECHO产前诊断的冠心病患者。排除标准如下：多胎妊娠、终止妊娠、已知遗传异常、心外异常。根据血流动力学因素将病例分为6组。胎儿生长受限（FGR）、先兆子痫（PE）、妊娠高血压（PIH）和宫内胎儿死亡（IUFD）的参考值来自荷兰和/或欧洲的总体人群。结果：经排除后，有1293例可供分析。FGR的发生率为198/1247（15.9%）。冠心病组间FGR差异有统计学意义（p = 0.002），但与主动脉流量和氧合无相关性。与参考值相比，我们的队列中PE（64/1282, 5.0%）、PIH（43/1284, 3.3%）和IUFD（33/1291, 2.6%）的发生率较高。然而，不同冠心病组之间的PE、PIH和IUFD没有差异。结论：不良胎盘综合征的发生率较高，但与胎儿血流动力学无关。即使在没有血流动力学改变的冠心病患者中，这些并发症的发生率也很高。这可能是影响胎盘和胎儿心脏的早期胚胎发育途径的临床表现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prenatal Diagnosis 医学-妇产科学

CiteScore

5.80

自引率

13.30%

发文量

204

审稿时长

2 months

期刊介绍： Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling