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Background: Studies show that an impaired maternal-fetal environment (iMFE) increases the mortality risk in children with single-ventricle congenital heart defects (CHDs). We investigated the impact of an iMFE on death in children with various surgically corrected CHDs.
Methods And Results: In this nationwide register-based study, we examined the association between an iMFE (including preeclampsia, gestational hypertension, gestational diabetes, maternal smoking during pregnancy) and death in a large cohort of children with surgically corrected CHDs in Denmark (1994-2018). Survival analysis was done using Cox regression, adjusted for confounding and mediating covariates. The cohort included 3304 children: 1662 (50.3%) with minor CHD and 1642 (49.7%) with major CHD. Among them, 792 (24%) children were exposed to an iMFE. During the study, there were 290 deaths: 71 (9.3%) in children exposed to an iMFE and 219 (8.7%) in those unexposed. There were no differences in mortality risk between children with CHD exposed to an iMFE and those unexposed (hazard ratio [HR], 1.12 [95% CI, 0.86-1.47]; =0.4). This was consistent across subgroups, including minor CHD (HR, 0.76 [95% CI, 0.39-1.47]; =0.4), major CHD (HR, 1.23 [95% CI, 0.92-1.64]; =0.2), and hypoplastic left heart syndrome/univentricular heart (HR, 1.08 [95% CI, 0.64-1.85]; =0.8).
Conclusions: Impairment of the maternal-fetal environment did not impact the mortality rate in children with CHD undergoing operation in Denmark from 1994 to 2018. We believe the cause of these discrepant findings to previous studies may be due to differences in the composition of CHD and prenatal maternal health care and health status of the population.
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http://dx.doi.org/10.1161/JAHA.123.031575 | DOI Listing |
J Med Virol
December 2024
Division of Microbiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan.
Placental trophoblasts constitute the interface between the fetal and maternal environments and physically prevent maternal-fetal viral transmission. However, congenital human cytomegalovirus (HCMV) infection in the early stages of pregnancy results in severe symptoms in the fetus. HCMV is the most common causative agent of intrauterine infection.
View Article and Find Full Text PDFActa Paediatr
December 2024
0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini (Lecco), Italy.
Background: The Special Issue articles describe six systems of parental interventions and developmental care several differences among each of the approaches. Nevertheless, on a deeper level there are profound similarities shared across the six systems. These similarities are at the heart of developmental care in general and parental interventions in particular.
View Article and Find Full Text PDFArterioscler Thromb Vasc Biol
December 2024
Department of Pathology and Laboratory Medicine, Endeavor Health, The University of Chicago Pritzker School of Medicine. (L.M.E.).
Background: Evidence suggests that the intrauterine environment shapes offspring cardiovascular disease risk. Although placental dysfunction may be an important pathophysiologic pathway, numerous parental and pregnancy characteristics that influence offspring blood pressure are strong confounders of the mechanistic role of the placenta in observational analyses of singletons. Therefore, we leverage twin- and sibling-based comparison designs to determine whether placental pathology is associated with offspring blood pressure at age 7 while mitigating major sources of confounding.
View Article and Find Full Text PDFBMC Psychol
December 2024
Center for Nursing Research, Shantou University Medical College, Shantou, Guangdong, 515041, China.
Background: Patients undergoing assisted reproductive technology (ART) experience significant psychological distress due to infertility, with depression and anxiety being the most common manifestations. This study investigates the influence of family support and self-efficacy on the mental health of patients undergoing in vitro fertilization-embryo transfer (IVF-ET). The aim is to assess the direct and indirect effects of family function and self-efficacy on depression and anxiety in IVF-ET patients through pathway analyses, thereby providing novel insights for improving patients' psychological well-being.
View Article and Find Full Text PDFBMC Med Imaging
December 2024
Chennai Institute of Technology, Chennai, India.
Ultrasound (US) imaging is an essential diagnostic technique in prenatal care, enabling enhanced surveillance of fetal growth and development. Fetal ultrasonography standard planes are crucial for evaluating fetal development parameters and detecting abnormalities. Real-time imaging, low cost, non-invasiveness, and accessibility make US imaging indispensable in clinical practice.
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