Placental Characteristics of Fetuses with Congenital Heart Disease

Afaf Albalawi, Flavia Brancusi, Frederic B Askin, Robert Ehsanipoor, Jiangxia Wang, Irina Burd, Priya Sekar

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)965-972
Number of pages8
JournalJournal of Ultrasound in Medicine
Volume36
Issue number5
DOIs
StatePublished - May 1 2017

Keywords

  • congenital heart disease
  • general and abdominal ultrasound
  • placenta-to-birth weight ratio
  • placental abnormalities
  • umbilical cord insertion

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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