{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T23:04:05Z","timestamp":1780009445231,"version":"3.53.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to describe severity-stratified early outcomes in pregnancies with prenatally suspected laterality spectrum disorders (LSD), defined as abnormalities of left\u2013right body patterning affecting thoracoabdominal situs and associated cardiovascular and visceral structures, and to explore phenotype patterns associated with pregestational diabetes mellitus (PDM).<\/jats:p>\n                  <jats:p>Retrospective cohort study of pregnancies evaluated at a tertiary fetal care and fetal cardiology referral center (2010\u20132026). LSD subtype was assigned using a prespecified operational framework. Cardiac severity was classified as major versus nonmajor congenital heart disease (CHD). Outcomes included termination, intrauterine fetal demise (IUFD), neonatal survival (\u226428 days), infant survival (28 days\u20131 year), cardiac surgery, and gastrointestinal morbidity.<\/jats:p>\n                  <jats:p>Seventy-eight pregnancies were included; 16\/78 (20.5%) had PDM. Major CHD was present in 49\/78 (62.8%). Pregnancy outcomes included live birth in 62\/78 (79.5%), IUFD in 5\/78 (6.4%), and termination in 11\/78 (14.1%); all terminations occurred among major CHD cases. Among live births, neonatal survival was 59\/62 (95.2%), and infant survival among neonatal survivors was 46\/53 (86.8%). In major CHD live births (n\u2009=\u200933), neonatal survival was 30\/33 (90.9%) and infant survival among neonatal survivors with available follow-up was 20\/27 (74.1%). Cardiac surgery occurred in 22\/62 (35.5%) and was more common in major versus nonmajor CHD (63.6 vs. 3.4%). Intestinal malrotation occurred in 18\/62 (29.0%). Abdominal situs inversus was more frequent in PDM pregnancies (37.5 vs. 8.1%).<\/jats:p>\n                  <jats:p>In LSD, major CHD drives pregnancy termination, surgical intervention, and early mortality concentrated during infancy. PDM was associated with a higher frequency of abdominal situs phenotypes, supporting deliberate postnatal gastrointestinal surveillance planning.<\/jats:p>","DOI":"10.1055\/a-2852-5042","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T23:03:59Z","timestamp":1776121439000},"page":"1051-1058","source":"Crossref","is-referenced-by-count":0,"title":["Laterality Spectrum Disorders in the Prenatal Era: Outcomes Across the Severity Spectrum and Associations with Pregestational Diabetes"],"prefix":"10.1055","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2739-3951","authenticated-orcid":false,"given":"Kunio","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"},{"name":"Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Seger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Tieu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Witcher","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozhan","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sifa","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1002\/1096-8628(2000)9999:999<00::AID-AJMG1139>3.0.CO;2-Z","article-title":"Heterotaxia as an outcome of maternal diabetes: an epidemiological study","volume":"99","author":"M L Mart\u00ednez-Fr\u00edas","year":"2001","journal-title":"Am J Med Genet"},{"issue":"38","key":"ref2","doi-asserted-by":"crossref","first-page":"E5300","DOI":"10.1073\/pnas.1504529112","article-title":"Hyperglycemia impairs left-right axis formation and thereby disturbs heart morphogenesis in mouse embryos","volume":"112","author":"M Hachisuga","year":"2015","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"2581","DOI":"10.1002\/ajmg.a.36695","article-title":"Laterality defects in the national birth defects prevention study (1998-2007): birth prevalence and descriptive epidemiology","volume":"164A","author":"A E Lin","year":"2014","journal-title":"Am J Med Genet A"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s00059-010-3244-3","article-title":"Congenital heart disease in pregnancies complicated by maternal diabetes mellitus. 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