Chrystalle Katte Carreon, Christina Ronai, Julia K Hoffmann, Wayne Tworetzky, Sarah U Morton, Louise E Wilkins-Haug
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The significance threshold was set at p < 0.05 or False Discovery rate q < 0.05 when multiple tests were performed.</p><p><strong>Results: </strong>The cohort included 215 FCHD and 122 non-FCHD placentas. FCHD placentas showed increased rates of maternal vascular malperfusion (24% vs. 5%, q < 0.001) and cord anomalies (27% vs. 1%, q < 0.001). Placentas with fetal TGA demonstrated a lower rate of hypoplasia when compared with other FCHD types (1/39 vs. 51/176, Fisher's exact p = 0.015).</p><p><strong>Conclusion: </strong>Placental maternal vascular malperfusion is increased in FCHD. The prevalence of vascular malperfusion did not differ by FCHD type, indicating that CHD type does not predict the likelihood of placental vascular dysfunction. Further investigation of the placental-fetal heart axis in FCHD is warranted given the importance of placental health.</p>","PeriodicalId":20387,"journal":{"name":"Prenatal Diagnosis","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Maternal Vascular Malperfusion and Anatomic Cord Abnormalities Are Prevalent in Pregnancies With Fetal Congenital Heart Disease.\",\"authors\":\"Chrystalle Katte Carreon, Christina Ronai, Julia K Hoffmann, Wayne Tworetzky, Sarah U Morton, Louise E Wilkins-Haug\",\"doi\":\"10.1002/pd.6650\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Impairments in the maternal-fetal environment are associated with adverse postnatal outcomes among infants with congenital heart disease. 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引用次数: 0
摘要
目的:母胎环境的损害与患有先天性心脏病的婴儿的不良产后预后有关。因此,我们试图研究胎盘异常与各种形式的胎儿先天性心脏病(FCHD)的关系:我们对患有和未患有先天性心脏病的单胎妊娠胎盘病理学进行了回顾性研究。胎盘先天性心脏病分为不同类别(转位性生理性、左侧梗阻性、右侧梗阻性、双室无梗阻性及其他)。排除标准包括产前已知的其他结构畸形和/或非整倍体。显著性阈值设定为 p 结果:组群包括215个FCHD胎盘和122个非FCHD胎盘。FCHD胎盘的母体血管灌注不良率增加(24% vs. 5%,q 结论:胎盘母体血管灌注不良在 FCHD 中增加。血管灌注不良的发生率并不因 FCHD 类型而异,这表明 CHD 类型并不能预测胎盘血管功能障碍的可能性。鉴于胎盘健康的重要性,有必要进一步研究 FCHD 胎盘-胎儿心脏轴。
Maternal Vascular Malperfusion and Anatomic Cord Abnormalities Are Prevalent in Pregnancies With Fetal Congenital Heart Disease.
Objective: Impairments in the maternal-fetal environment are associated with adverse postnatal outcomes among infants with congenital heart disease. Therefore, we sought to investigate placental anomalies as they related to various forms of fetal congenital heart disease (FCHD).
Methods: We reviewed the placental pathology in singleton pregnancies with and without FCHD. FCHD was divided into separate categories (transposition physiology, obstructive left, obstructive right, biventricular without obstruction, and others). Exclusion criteria included other prenatally known structural malformations and/or aneuploidy. The significance threshold was set at p < 0.05 or False Discovery rate q < 0.05 when multiple tests were performed.
Results: The cohort included 215 FCHD and 122 non-FCHD placentas. FCHD placentas showed increased rates of maternal vascular malperfusion (24% vs. 5%, q < 0.001) and cord anomalies (27% vs. 1%, q < 0.001). Placentas with fetal TGA demonstrated a lower rate of hypoplasia when compared with other FCHD types (1/39 vs. 51/176, Fisher's exact p = 0.015).
Conclusion: Placental maternal vascular malperfusion is increased in FCHD. The prevalence of vascular malperfusion did not differ by FCHD type, indicating that CHD type does not predict the likelihood of placental vascular dysfunction. Further investigation of the placental-fetal heart axis in FCHD is warranted given the importance of placental health.
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