Shared developmental pathways of the placenta and fetal heart

Area of Science:

• Cardiovascular Science
• Developmental Biology
• Perinatal Medicine

Background:

• Congenital heart defects (CHD) are the most common birth defects, affecting 1 in 110 live births globally.
• Pregnancies with fetal CHD exhibit indicators of placental dysfunction, with emerging evidence highlighting molecular links between the embryonic heart and placenta.
• A hostile intrauterine environment, driven by placental maldevelopment, may negatively impact fetal development and contribute to CHD subtypes.

Approach:

• This review synthesizes current clinical, structural, and molecular data on the relationship between CHD and placental dysfunction.
• It examines how CHD subtypes influence these placental changes.
• The review discusses limitations of current animal models and advocates for improved non-invasive placental assessment in human-specific studies.

Key Points:

• Placental dysfunction is a significant factor in the adverse in-utero environment of CHD pregnancies.
• The etiological role of the placenta in CHD development requires further clarification.
• Current animal models have limitations in assessing both fetal heart and placental development concurrently.

Conclusions:

• Improved non-invasive placental assessment methods are crucial for advancing human-specific research on the placenta-heart axis in CHD.
• Understanding the placenta-heart axis is vital for elucidating CHD etiology and improving fetal development outcomes.
• Future research should focus on human-specific investigations to better model the complex interactions between the developing heart and placenta.