Placental hypoplasia and vascular malperfusion are associated with reduced brain volumes in fetal congenital heart disease

BACKGROUND: Critical congenital heart disease (CHD) is associated with poor neurodevelopmental outcomes and long-term psychosocial morbidity. The pre-natal environment is increasingly recognized as a critical effector. However, the association of specific placental lesions with fetal brain volume in CHD remains unexamined. METHODS: This was a multi-site prospective, nested case-control study, that recruited pregnant women with typical fetal development and prenatally diagnosed fetal CHD. Fetal brain MRI was performed at 32.8 ± 3.0 weeks gestation. Placentas were examined pathologically after delivery. Clinical characteristics were gathered from self-reports and medical charts. Multiple linear regression modeling was performed in R with p < 0.05 considered significant. RESULTS: Placental hypoplasia (weight