{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:46:13Z","timestamp":1792107973769,"version":"4.4.0"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Critical congenital heart disease (CHD) is associated with poor neurodevelopmental outcomes and long-term psychosocial morbidity. The pre-natal environment is increasingly recognized as a critical effector. However, the association of specific placental lesions with fetal brain volume in CHD remains unexamined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a multi-site prospective, nested case-control study, that\u00a0recruited pregnant women with typical fetal\u00a0development and prenatally diagnosed fetal CHD. Fetal brain MRI was performed at 32.8\u2009\u00b1\u20093.0 weeks gestation. Placentas were examined pathologically after delivery. Clinical characteristics were gathered from self-reports and medical charts. Multiple linear regression modeling was performed in R with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Placental hypoplasia (weight &lt;10th %ile) was associated with lower total fetal intracranial volume in CHD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) and combined (CHD + non-CHD) cohorts (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Maternal and\/or fetal vascular malperfusion was also associated with lower total fetal intracranial volume in combined (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026), and non-CHD cohorts (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020). Presence of any placental pathology was associated with reduced total fetal intracranial volume (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047), an effect moderated by the presence of CHD (interaction term\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Placental hypoplasia, vascular malperfusion, and the presence of any placental pathology are associated with decreased total intracranial volumes in-utero. Fetuses with CHD and concomitant placental lesions appear particularly susceptible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Placental vascular malperfusion is associated with reduced fetal intracranial volume.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Placental hypoplasia (weight &lt;10th %ile) is associated with smaller intracranial volumes in fetal congenital heart disease.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Placental pathologies uniquely affect in-utero brain development in congenital heart disease.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>This study is the first to link fetal brain development to specific placental pathologies using standardized, reproducible criteria (Amsterdam) with comparative inclusion of a non-congenital heart disease cohort.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Evidence builds that the in-utero environment impacts neurodevelopment in congenital heart disease; this study points to specific placental lesions that may mediate the pathophysiology underlying these observations.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-025-04698-3","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T10:24:13Z","timestamp":1767781453000},"page":"1266-1275","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Placental hypoplasia and vascular malperfusion are associated with reduced brain volumes in fetal congenital heart disease"],"prefix":"10.1038","volume":"100","author":[{"given":"Claire","family":"Baldauf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Rosas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Zamiara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T.","family":"Reynolds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nhu","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Ceschin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodie K.","family":"Votava-Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Wisnowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidya","family":"Rajagopalan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"4698_CR1","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","volume":"39","author":"JIE Hoffman","year":"2002","unstructured":"Hoffman, J. 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