Brain volumes in fetuses with congenital heart disease and placental vascular abnormalities.

OBJECTIVE

Investigate the association between placental vascular abnormalities and regional brain volumes in congenital heart disease (CHD) fetuses with and without genetic abnormalities.

STUDY

DESIGN

Secondary analysis of brain magnetic resonance imaging (MRI) and placental pathology data from 121 CHD fetuses enrolled in prospective neuroimaging studies at two centers.

RESULTS

Placental vascular abnormality was present in 46% of fetuses, and genetic abnormality was present in 19%, including 12% with both abnormalities. Fetuses with the combination of placental and genetic abnormalities had smaller brain volumes compared to fetuses without either abnormality for total brain, subcortical gray matter, brainstem, and cerebellum, with a significant interaction (P < 0.05) between placental and genetic abnormalities for intracranial and subcortical gray matter volumes.

CONCLUSION

Smaller brain volumes for CHD fetuses with placental and genetic abnormalities may suggest common genetic pathways affect placental, heart, and brain development, or that genetic abnormalities heighten vulnerability when placental changes occur.