Congenital Heart Diseases and Neurodevelopmental Disorders: New Insights Through the DOHaD Hypothesis

Area of Science:

• Developmental biology
• Perinatology
• Neuroscience

Background:

• Congenital heart disease (CHD) is the leading cause of birth defects, impacting 9 in 1,000 live births.
• Up to 50% of infants with CHD develop neurodevelopmental disorders, often without clear postnatal causes.
• The Developmental Origins of Health and Disease hypothesis suggests in utero factors influence later health outcomes.

Purpose of the Study:

• To review the intricate relationship between placental, cardiac, and cerebral tissues in CHD.
• To elucidate how placental dysfunction impacts fetal heart and brain development.
• To highlight the potential of placental research for early identification of neurodevelopmental risks in CHD infants.

Main Methods:

• Comprehensive literature review of studies investigating placental, cardiac, and cerebral interactions in CHD.
• Analysis of mechanisms linking placental dysregulation to developmental processes.
• Synthesis of evidence supporting the role of the placenta in neurodevelopmental outcomes.

Main Results:

• Placental dysregulation can adversely affect fetal vasculogenesis, angiogenesis, neural tube closure, hemodynamics, and energy supply.
• In utero placental dysfunction influences endocrine and epigenetic regulation critical for heart and brain development.
• A triangular interplay exists between the placenta, fetal heart, and brain in the context of CHD.

Conclusions:

• The placenta plays a pivotal role in fetal development and is implicated in CHD-associated neurodevelopmental disorders.
• Identifying placental biomarkers could enable early risk stratification for neurodevelopmental issues in CHD infants.
• Targeted, personalized interventions based on placental research hold promise for improving outcomes in affected infants.