TY - JOUR
T1 - Pregnancy Complications in Fetal Congenital Heart Disease
T2 - A Result of Common Early Developmental Pathways Rather Than Fetal Hemodynamics
AU - Snoep, Maartje C.
AU - Demir, Damla
AU - Roestenburg, Anouk M. C.
AU - Pajkrt, Eva
AU - van Leeuwen, Elisabeth
AU - Linskens, Ingeborg H.
AU - Knobbe, Ingmar
AU - Clur, Sally-Ann
AU - Rozendaal, Lieke
AU - van der Meeren, Lotte E.
AU - Haak, Monique C.
N1 - Publisher Copyright:
© 2025 The Author(s). Prenatal Diagnosis published by John Wiley & Sons Ltd.
PY - 2025/8
Y1 - 2025/8
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/105006737629
U2 - 10.1002/pd.6819
DO - 10.1002/pd.6819
M3 - Article
C2 - 40420225
SN - 0197-3851
VL - 45
SP - 1122
EP - 1129
JO - Prenatal diagnosis
JF - Prenatal diagnosis
IS - 9
ER -
