Details

Autor(en) / Beteiligte

• Linn, Rebecca L
• Gaynor, James W
• Moldenhauer, Julie
• Rychik, Jack
• Yu, Sunkyung
• Parry, Samuel I
• Nicolson, Susan C
• Elovitz, Michal
• Simmons, Rebecca
• Burnham, Nancy
• Johnson, Mark
• Sampson, Matthew
• Hakonarson, Hakon
• Russell, Mark W

Titel

Abstract 11176: Placental Villous Infarcts Are a Marker of Impaired Fetal Growth and Poor Post-surgical Outcome in Infants With Critical Congenital Heart Defects

Ist Teil von

• Circulation (New York, N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A11176-A11176

Ort / Verlag

by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2019

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• IntroductionThe placenta plays a key role in supporting fetal growth and development with the ability to respond to changes in the maternal environment. We have shown that pregnancies with congenital heart defects (CHD) and evidence of impaired maternal fetal environment are associated with poor survival after cardiac surgery. In this study, we investigated the relationship of pathologic markers of placental insufficiency to the burden of proangiogenic gene damaging variants and intermediate survival.MethodsMother/infant dyads with CHD at The Children’s Hospital of Philadelphia requiring surgical repair within the first 6 months of life were recruited. Medical records were reviewed for clinical data. Standardized placental pathologic findings were recorded. Exome sequencing was performed and the GeneVetter analysis tool was used to identify damaging coding sequence variants in 160 genes associated with positive regulation of angiogenesis (PRA) (GO:0045766).ResultsA total of 79 subjects were analyzed. The mean gestational age at delivery was 38.5±1.2 weeks. Placental villous infarction was present in 21 (27%) and more than one infarct was present in 8 of 21 (38%). Infarcts were significantly associated with reduced weight and length for age z-scores at birth (mean -0.42 and -1.14 with infarct vs 0.04 and 0.05 without; P=0.046 and 0.0005, respectively). The presence of an infarct was associated with lower survival (Figure74.6% vs. 93.1% at 3 years; P=0.047). While the presence of damaging PRA variants in the infant was not associated with placental infarct, multiple infarcts were associated with 1 or more damaging PRA variants in the mother (P=0.02).ConclusionIn pregnancies involving a fetus with CHD, placental infarction is associated with impaired fetal growth and poor survival after cardiac surgery. The association of infarcts with maternal damaging PRA variants suggests an underlying genetic predisposition that merits future study.