Placental vascular abnormality is associated with worse neurodevelopmental outcomes for infants with congenital heart disease and genetic abnormality

IF 2.1 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Early human development Pub Date : 2026-02-01 Epub Date: 2025-11-25 DOI:10.1016/j.earlhumdev.2025.106456

Kelly L. Meyer , Clare O'Hare , Mai He , Gillian Mayersohn , Avihu Z. Gazit , Anthony Odibo , Jinli Wang , Cynthia M. Ortinau

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引用次数: 0

Abstract

Objective

Determine the association of placental vascular abnormality with neurodevelopment (ND) in toddlers with congenital heart disease (CHD) requiring intervention with cardiopulmonary bypass (CPB) in the first year of life.

Study design

This single center retrospective cohort study included 69 singleton, term-born infants with prenatally diagnosed CHD requiring CPB in infancy who had placental pathology data and underwent ND follow-up assessment with the Bayley Scales of Infant and Toddler Development (Bayley). Infants with a clinically diagnosed genetic abnormality were included. Placental vascular abnormality was defined as maternal vascular malperfusion, fetal vascular malperfusion, or delayed villous maturation. Multivariable regression models were used to assess the association between placental vascular abnormality and Bayley scores.

Results

Placental vascular abnormality was present in 43 % (30/69) of the cohort and was associated with lower Bayley language and motor scores on univariate analysis. A significant interaction was identified between placental vascular abnormality and genetic abnormality, which occurred in 26 % (18/69) of the cohort. In multivariable models, compared to infants with genetic abnormality alone, infants with placental vascular abnormality and genetic abnormality had lower cognitive (group difference –18.4, 95 % CI –30.7, −6.1), language (group difference –27.5, 95 % CI –41.2, −13.9), and motor (group difference –27.6, 95 % CI –40.9, −14.2) composite scores. There was no association of placental vascular abnormality with ND scores for infants without genetic abnormality in multivariable models.

Conclusion

Placental vascular abnormalities are associated with worse ND outcomes in infants with CHD when a genetic abnormality is also present.

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胎盘血管异常与先天性心脏病和遗传异常婴儿较差的神经发育结局相关

目的探讨1岁前需要体外循环干预的先天性心脏病患儿胎盘血管异常与神经发育（ND）的关系。研究设计：本单中心回顾性队列研究纳入69例单胎足月婴儿，产前诊断为CHD，需要婴儿期CPB，有胎盘病理资料，并采用Bayley婴幼儿发育量表（Bayley Scales of婴幼儿发育量表）进行ND随访评估。包括临床诊断为遗传异常的婴儿。胎盘血管异常被定义为母体血管灌注不良、胎儿血管灌注不良或绒毛成熟延迟。采用多变量回归模型评估胎盘血管异常与贝利评分之间的关系。结果43%（30/69）的队列患者存在胎盘血管异常，单因素分析显示胎盘血管异常与较低的Bayley语言和运动评分有关。胎盘血管异常和遗传异常之间存在显著的相互作用，26%（18/69）的队列发生了这种相互作用。在多变量模型中，与单纯遗传异常的婴儿相比，胎盘血管异常和遗传异常的婴儿的认知（组差-18.4,95% CI -30.7,−6.1）、语言（组差-27.5,95% CI -41.2,−13.9）和运动（组差-27.6,95% CI -40.9,−14.2）综合评分较低。在多变量模型中，没有遗传异常的婴儿胎盘血管异常与ND评分没有关联。结论胎盘血管异常与先天性先天性冠心病患儿较差的ND预后相关。

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

Early human development 医学-妇产科学

CiteScore

4.40

自引率

4.00%

发文量

100

审稿时长

46 days

期刊介绍： Established as an authoritative, highly cited voice on early human development, Early Human Development provides a unique opportunity for researchers and clinicians to bridge the communication gap between disciplines. Creating a forum for the productive exchange of ideas concerning early human growth and development, the journal publishes original research and clinical papers with particular emphasis on the continuum between fetal life and the perinatal period; aspects of postnatal growth influenced by early events; and the safeguarding of the quality of human survival. The first comprehensive and interdisciplinary journal in this area of growing importance, Early Human Development offers pertinent contributions to the following subject areas: Fetology; perinatology; pediatrics; growth and development; obstetrics; reproduction and fertility; epidemiology; behavioural sciences; nutrition and metabolism; teratology; neurology; brain biology; developmental psychology and screening.