Placental Malperfusion Is Associated With Adverse Outcomes in Congenital Heart Disease and With Genetic Variants in Placental Developmental Pathways
Authors' conclusion
PMP is associated with impaired fetal growth, longer hospitalization, and possibly increased mortality in CHD. CHD fetuses with PMP harbor deleterious de novo variants in several key placental and cardiac developmental pathways, which may represent important mechanisms underlying PMP in CHD.
Study context
- Population
- Fetuses with congenital heart disease (CHD)Placental malperfusion (PMP) in 51%
- Participants
- 299 fetuses
- Comparison
- CHD fetuses with PMP vs without PMP
- Outcome
- Adverse outcomes and genomic variation in vascular or placental developmental pathways
Main finding
As reported in the abstract
Outcomes in nonsyndromic fetuses
PMP
- Birth weight
- 2,986 g
- Length
- 48 cm
- Head circumference
- 33 cm
- Index hospitalization
- 21 days
- Mortality
- 12.3%
n = 122
No PMP
- Birth weight
- 3,330 g
- Length
- 48.9 cm
- Head circumference
- 34 cm
- Index hospitalization
- 15 days
- Mortality
- 5.6%
n = 124
Birth weight
PMP n = 1222,986 g
No PMP n = 1243,330 g
Length
PMP n = 12248 cm
No PMP n = 12448.9 cm
Head circumference
PMP n = 12233 cm
No PMP n = 12434 cm
Index hospitalization
PMP n = 12221 days
No PMP n = 12415 days
Mortality
PMP n = 12212.3%
No PMP n = 1245.6%
PMP vs No PMPEstimate (95% CI)P value
Mortality, univariable
unadjusted HR 1.5(1.03–2.17)
P = 0.03Mortality, multivariable
adjusted HR 1.44(0.995–2.09)
P = 0.054Observational data: associations, not effects.
Further findings
Outcomes in syndromic subjects (subgroup)
- No significant differences in syndromic subjects
Genomic variants
- Proportion with ≥1 angiogenesis pathway or de novo variant similar with and without PMP, not associated with outcomes
- Fetuses with PMP: distinct enrichment in de novo variants in Notch signaling and extracellular matrix regulation/epithelial-to-mesenchymal transition genes
Original publication
Placental Malperfusion Is Associated With Adverse Outcomes in Congenital Heart Disease and With Genetic Variants in Placental Developmental Pathways. J Am Coll Cardiol. Published 11 November 2025. doi:10.
Summarised from the published abstract; every number is checked against it