title: Congenital Heart Defects and Indices of Placental and Fetal Growth in a Nationwide Study of 924 422 Liveborn Infants.
abstract: BACKGROUND
  Congenital heart defects (CHDs) have been associated with placental anomalies. The nature and the consequences of this association remain poorly understood. We aimed to estimate the associations between all major subtypes of CHD and placental weight at birth, and the association between placental weight and measures of both overall and cerebral growth in fetuses with CHD, as well.
  
  
  METHODS
  We included all 924 422 liveborn Danish singletons, 1997 to 2011. CHD was present in 7569. We compared mean differences in placental weight z score between newborns with CHD and newborns without CHD by multivariable linear regression adjusted for potential confounders.
  
  
  RESULTS
  CHD was associated with a mean z score difference of -0.04 (95% confidence interval, -0.07 to -0.02). Some subtypes were associated with smaller placental size at birth: tetralogy of Fallot, -0.45 (95% confidence interval, -0.58 to -0.31); double-outlet right ventricle, -0.48 (95% confidence interval, -0.87 to -0.10); major ventricular septal defects, -0.41 (95% confidence interval, -0.52 to -0.29). Placental weight z score was associated with birth weight and head circumference z scores in all subtypes. In the 3 mentioned subtypes, the mean deviations from the population mean head circumference and birth weight z scores were reduced by up to 66% with adjustment for placental weight z score.
  
  
  CONCLUSIONS
  Three subtypes of CHD were associated with lower placental weight, and placental weight was associated with measures of both overall growth and cerebral growth in fetuses with all subtypes of CHD. In certain subtypes, the described deviations in fetal growth were reduced by up to two-thirds after adjustment for placental weight z score.
authors.affiliation: From Department of Pediatrics, Aarhus University Hospital, Denmark (N.B.M., T.B.H., P.A., C.C.B., J.R.O.); Centre for Rare Diseases, Aarhus University Hospital, Denmark (N.B.M., P.A., J.R.O.); Perinatal Epidemiology Research Unit, Aarhus University Hospital, Denmark (N.B.M., T.B.H., C.C.B.); Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, PA (J.W.G.); and Department of Cardiothoracic Surgery, Aarhus University Hospital, Denmark (V.H.). nielsbm@ki.au.dk.
authors.forename: Niels B
authors.initials: NB
authors.lastname: Matthiesen
authors.affiliation: From Department of Pediatrics, Aarhus University Hospital, Denmark (N.B.M., T.B.H., P.A., C.C.B., J.R.O.); Centre for Rare Diseases, Aarhus University Hospital, Denmark (N.B.M., P.A., J.R.O.); Perinatal Epidemiology Research Unit, Aarhus University Hospital, Denmark (N.B.M., T.B.H., C.C.B.); Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, PA (J.W.G.); and Department of Cardiothoracic Surgery, Aarhus University Hospital, Denmark (V.H.).
authors.forename: Tine B
authors.initials: TB
authors.lastname: Henriksen
authors.affiliation: From Department of Pediatrics, Aarhus University Hospital, Denmark (N.B.M., T.B.H., P.A., C.C.B., J.R.O.); Centre for Rare Diseases, Aarhus University Hospital, Denmark (N.B.M., P.A., J.R.O.); Perinatal Epidemiology Research Unit, Aarhus University Hospital, Denmark (N.B.M., T.B.H., C.C.B.); Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, PA (J.W.G.); and Department of Cardiothoracic Surgery, Aarhus University Hospital, Denmark (V.H.).
authors.forename: Peter
authors.initials: P
authors.lastname: Agergaard
authors.affiliation: From Department of Pediatrics, Aarhus University Hospital, Denmark (N.B.M., T.B.H., P.A., C.C.B., J.R.O.); Centre for Rare Diseases, Aarhus University Hospital, Denmark (N.B.M., P.A., J.R.O.); Perinatal Epidemiology Research Unit, Aarhus University Hospital, Denmark (N.B.M., T.B.H., C.C.B.); Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, PA (J.W.G.); and Department of Cardiothoracic Surgery, Aarhus University Hospital, Denmark (V.H.).
authors.forename: J William
authors.initials: JW
authors.lastname: Gaynor
authors.affiliation: From Department of Pediatrics, Aarhus University Hospital, Denmark (N.B.M., T.B.H., P.A., C.C.B., J.R.O.); Centre for Rare Diseases, Aarhus University Hospital, Denmark (N.B.M., P.A., J.R.O.); Perinatal Epidemiology Research Unit, Aarhus University Hospital, Denmark (N.B.M., T.B.H., C.C.B.); Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, PA (J.W.G.); and Department of Cardiothoracic Surgery, Aarhus University Hospital, Denmark (V.H.).
authors.forename: Cathrine C
authors.initials: CC
authors.lastname: Bach
authors.affiliation: From Department of Pediatrics, Aarhus University Hospital, Denmark (N.B.M., T.B.H., P.A., C.C.B., J.R.O.); Centre for Rare Diseases, Aarhus University Hospital, Denmark (N.B.M., P.A., J.R.O.); Perinatal Epidemiology Research Unit, Aarhus University Hospital, Denmark (N.B.M., T.B.H., C.C.B.); Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, PA (J.W.G.); and Department of Cardiothoracic Surgery, Aarhus University Hospital, Denmark (V.H.).
authors.forename: Vibeke E
authors.initials: VE
authors.lastname: Hjortdal
authors.affiliation: From Department of Pediatrics, Aarhus University Hospital, Denmark (N.B.M., T.B.H., P.A., C.C.B., J.R.O.); Centre for Rare Diseases, Aarhus University Hospital, Denmark (N.B.M., P.A., J.R.O.); Perinatal Epidemiology Research Unit, Aarhus University Hospital, Denmark (N.B.M., T.B.H., C.C.B.); Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, PA (J.W.G.); and Department of Cardiothoracic Surgery, Aarhus University Hospital, Denmark (V.H.).
authors.forename: John R
authors.initials: JR
authors.lastname: Østergaard
mesh_terms: D001724:Birth Weight; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010920:Placenta / Q000503:physiopathology*; D011247:Pregnancy
keywords: birth weight; congenital; fetal development; head circumference; heart defects; pediatrics; placenta; pregnancy