The Relationship Between Placental Pathology and Neurodevelopmental Outcomes in Complex Congenital Heart Disease. Pediatr Cardiol 2023 Jun;44(5):1143-1149
Date
10/07/2022Pubmed ID
36201029DOI
10.1007/s00246-022-03018-4Scopus ID
2-s2.0-85139472378 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
Complex congenital heart disease (CCHD) is associated with impaired neurodevelopmental outcomes. Peri- and post-operative factors are known contributors while the impact of the prenatal environment is not yet delineated. Variations in fetal circulation, seen in transposition of the great arteries (TGA) and single ventricular physiology (SVP), are associated with placenta abnormalities. These abnormalities may be associated with placental insufficiency, a risk factor for poor neurodevelopmental outcomes. We hypothesized there is a correlation between placental pathology and impaired neurodevelopmental outcomes in patients with CCHD. We performed a single center retrospective cohort study with patients with TGA and SVP from 2010 to 2017 at Children's Wisconsin. Patient variables were obtained from the medical record. Bayley Scales of Infant Development Third Edition standard scores for cognitive, motor, and language performance were collected from neurodevelopmental visits. Placenta pathology reports were reviewed with tabulation of predetermined anatomical and pathological characteristics. We identified 79 patients in our cohort and 61 (77.2%) had abnormal placentas. There was no significant difference between the two groups in any demographic or clinical variables. For cognitive and motor performance, without adjusting for the covariates, infants with placental abnormalities had significantly lower scores compared to infants without (p = 0.026, p = 0.045 respectively). Conversely, there was no significant difference in language scores between the two groups (p = 0.12). Placenta abnormalities are common in patients with CCHD, and placenta abnormalities are associated with impaired neurodevelopmental outcomes. These results underscore the complex causal pathways of neurodevelopmental impairment in infants with CCHD and offer opportunities for targeted postnatal developmental interventions after discharge.
Author List
Segar DE, Zhang J, Yan K, Reid A, Frommelt M, Cohen SAuthors
Susan Cohen MD Professor in the Pediatrics department at Medical College of WisconsinDavid Segar MD Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Ke Yan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
ChildDevelopmental Disabilities
Female
Heart Defects, Congenital
Humans
Infant
Neurodevelopmental Disorders
Placenta
Placenta Diseases
Pregnancy
Retrospective Studies
Transposition of Great Vessels
