title: Environmental origins of congenital heart disease: the heart-placenta connection.
abstract: Although the mammalian embryo is well protected in the uterus, environmental chemicals, drugs, and maternal nutritional imbalances can interfere with regulatory pathways directing placental and embryonic development early in gestation. Embryonic cells are most susceptible to environmental influences during cellular specification and differentiation stages. Because biochemical differentiation precedes morphological outcome often by days, the period of susceptibility to environmental chemicals expectedly precedes visible morphogenic effects. The cellular mechanisms by which drugs and other environmental factors disrupt embryonic development and induce cardiac abnormalities have remained undefined.
authors.affiliation: All Children's Hospital, Johns Hopkins Medicine, St Petersburg, FL, USA. Electronic address: aa4md@aol.com.
authors.forename: James
authors.initials: J
authors.lastname: Huhta
authors.forename: Kersti K
authors.initials: KK
authors.lastname: Linask
mesh_terms: D000818:Animals; D019587:Dietary Supplements; D018876:Environmental Illness / Q000151:congenital / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D004785:Environmental Pollutants / Q000633:toxicity; D005260:Female; D047109:Fetal Development / Q000187:drug effects; D005318:Fetal Heart / Q000187:drug effects / Q000503:physiopathology*; D005492:Folic Acid / Q000627:therapeutic use; D006330:Heart Defects, Congenital / Q000196:embryology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006331:Heart Diseases / Q000196:embryology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D010920:Placenta / Q000187:drug effects / Q000503:physiopathology*; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena
chemical_list: D004785:Environmental Pollutants; D005492:Folic Acid
keywords: Birth defects; Cardiac embryonic development; Congenital heart disease; Fetal echocardiography; Folate