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Placental Characteristics of Fetuses With Congenital Heart Disease
Author(s) -
Albalawi Afaf,
Brancusi Flavia,
Askin Frederic,
Ehsanipoor Robert,
Wang Jiangxia,
Burd Irina,
Sekar Priya
Publication year - 2017
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.16.04023
Subject(s) - medicine , fetus , heart disease , fetal heart , disease , cardiology , congenital disease , pregnancy , obstetrics , genetics , biology
Objectives To investigate whether there is an association between congenital heart disease (CHD) and placental abnormalities. Methods We conducted a case‐control study that included cases of infants with CHD who underwent cardiac surgery within 6 months of life at the Johns Hopkins Medical Center from 2000 to 2013, and gestational age‐matched normal pregnancy controls (200 neonates per group). Results Overall, abnormal placental cord insertion (ie, eccentric, marginal, or velamentous) was associated with CHD (odds ratio, 2.33–3.76). The main cardiac defects associated with abnormal cord insertion were conotruncal defects (relative risk, 3.08; 95% confidence interval [CI], 1.48–6.40; P = .003), left heart disease (relative risk, 2.40; 95% CI, 1.32–4.37; P = .004), and right heart disease (relative risk, 2.22; 95% CI, 1.21–4.07; P = .010). The Placenta‐to‐birth weight ratio was not associated with CHD. Intrauterine growth restriction was associated with CHD (odds ratio, 3.00; 95% CI, 1.41–6.39; P = .004). Conclusions Abnormal cord insertion, as well as intrauterine growth restriction, was determined to be correlated with the presence of CHD. On the basis of our results, we conclude that cord insertion should be evaluated at routine obstetric sonography, and further fetal heart evaluation is warranted if abnormal cord insertion is detected.