title: Placental Characteristics of Fetuses With Congenital Heart Disease.
abstract: OBJECTIVE
  To investigate whether there is an association between congenital heart disease (CHD) and placental abnormalities.
  
  
  METHODS
  We conducted a case-control study that included cases of infants with CHD who underwent cardiac surgery within 6 months of life at the Johns Hopkins Medical Center from 2000 to 2013, and gestational age-matched normal pregnancy controls (200 neonates per group).
  
  
  RESULTS
  Overall, abnormal placental cord insertion (ie, eccentric, marginal, or velamentous) was associated with CHD (odds ratio, 2.33-3.76). The main cardiac defects associated with abnormal cord insertion were conotruncal defects (relative risk, 3.08; 95% confidence interval [CI], 1.48-6.40; P = .003), left heart disease (relative risk, 2.40; 95% CI, 1.32-4.37; P = .004), and right heart disease (relative risk, 2.22; 95% CI, 1.21-4.07; P = .010). The Placenta-to-birth weight ratio was not associated with CHD. Intrauterine growth restriction was associated with CHD (odds ratio, 3.00; 95% CI, 1.41-6.39; P = .004).
  
  
  CONCLUSIONS
  Abnormal cord insertion, as well as intrauterine growth restriction, was determined to be correlated with the presence of CHD. On the basis of our results, we conclude that cord insertion should be evaluated at routine obstetric sonography, and further fetal heart evaluation is warranted if abnormal cord insertion is detected.
authors.affiliation: Department of Pediatrics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Afaf
authors.initials: A
authors.lastname: Albalawi
authors.affiliation: Departments of Gynecology and Obstetrics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Flavia
authors.initials: F
authors.lastname: Brancusi
authors.affiliation: Department of Pathology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Frederic
authors.initials: F
authors.lastname: Askin
authors.affiliation: Departments of Gynecology and Obstetrics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Ehsanipoor
authors.affiliation: Departments of Johns Hopkins School of Medicine, and Biostatistics Center, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Jiangxia
authors.initials: J
authors.lastname: Wang
authors.affiliation: Departments of Gynecology and Obstetrics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Irina
authors.initials: I
authors.lastname: Burd
authors.affiliation: Department of Pediatrics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Sekar
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D010920:Placenta / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000196:embryology; D011247:Pregnancy; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: congenital heart disease; general and abdominal ultrasound; placenta-to-birth weight ratio; placental abnormalities; umbilical cord insertion