ArticleJournal of the American Heart Association2019
Impaired Fetal Environment and Gestational Age: What Is Driving Mortality in Neonates With Critical Congenital Heart Disease?
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 41 citations in OpenAlex.
- Important Role of Renin-Angiotensin System and Vasopressin System in Cardiovascular, Metabolic and Psychogenic Disorders in Pregnancy and Early Postnatal Life: A Narrative Review.International journal of molecular sciences · 2026Review
- Placental hypoplasia and vascular malperfusion are associated with reduced brain volumes in fetal congenital heart disease.Pediatric research · 2026Article
- Environmental Exposures Influence Fetal Brain Growth and Risk of Neonatal Brain Injury in Congenital Heart Disease.Research square · 2025Article
- Neonates at Risk: Understanding the Impact of High-Risk Pregnancies on Neonatal Health.Medicina (Kaunas, Lithuania) · 2025Review
- Double Jeopardy: A Distinct Mortality Pattern Among Preterm Infants with Congenital Heart Disease.Pediatric cardiology · 2025Article
- Adverse Obstetric Outcomes in Pregnancies With Major Fetal Congenital Heart Defects.JAMA pediatrics · 2025Article
- Fetal heart diseases and neonatal mortality: Risk factors and management.Archives of gynecology and obstetrics · 2024Article
- Adverse fetal/neonatal and obstetric outcomes in pregnancies with both maternal and fetal heart disease.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Impact of Maternal-Fetal Environment on Outcomes Following the Hybrid Procedure in the Single Ventricle Population.Pediatric cardiology · 2024Article
- Impact of an Impaired Maternal-Fetal Environment on Death in Children With Congenital Heart Defects Undergoing Surgery in Denmark From 1994 to 2018.Journal of the American Heart Association · 2024Article
- The Association of Gestational Age and Size with Management Strategies and Outcomes in Symptomatic Neonatal Tetralogy of Fallot.Pediatric cardiology · 2024Article
- The Association between Birthweight and Use of Cardiovascular Medications: The Role of Health Behaviors.Journal of cardiovascular development and disease · 2023Article
- Neonatal Depression Is Associated With 1-Year Mortality in Critical Congenital Heart Disease.Journal of the American Heart Association · 2023Article
- Prenatal Congenital Heart Disease and Placental Phenotypes: Preserved Neonatal Weight Despite Small Placentas.JACC. Advances · 2023Article
- Placental delayed villous maturation is associated with fetal congenital heart disease.American journal of obstetrics and gynecology · 2023Article
- Fetal Brain Development in Congenital Heart Disease.The Canadian journal of cardiology · 2023Review
- The implications of an integrated management model of prenatal diagnosis/postnatal treatment for premature infants with critical congenital heart disease-a case-control study.Cardiovascular diagnosis and therapy · 2022Article
- Adverse Maternal Fetal Environment Partially Mediates Disparate Outcomes in Non-White Neonates with Major Congenital Heart Disease.The Journal of pediatrics · 2022Article
- Severe Maternal Morbidity in Pregnancies Complicated by Fetal Congenital Heart Disease.JACC. Advances · 2022Article
- Altered erythropoiesis in newborns with congenital heart disease.Pediatric research · 2022Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
Background Infants with critical congenital heart disease (CCHD) are more likely to be small for gestational age (SGA) or born to mothers with maternal placental syndrome. The objective of this study was to investigate the relationship between maternal placental syndrome, SGA, and gestational age (GA) on 1-year mortality in infants with CCHD. Methods and Results In a population-based administrative database of all live-born infants in California (2007-2012) we identified all infants with CCHD without chromosomal anomalies. Our primary predictor was an impaired fetal environment (IFE), defined as presence of maternal placental syndrome or SGA. We calculated hazard ratios to quantify the association between different components of IFE and 1-year mortality and conducted a causal mediation analysis to assess GA at birth as a mediator. We identified 6863 infants with CCHD. IFE was present in 25.1%. Infants with IFE were more likely to die than infants without IFE (16.6% versus 11.1%; hazard ratios 1.55, 95% CI 1.34-1.78). Only SGA (hazard ratios 1.76, 95% CI 1.50-2.05) and placental abruption (hazard ratios 1.70, 95% CI 1.17-2.48) were significantly associated with mortality; preeclampsia and gestational hypertension had no significant association with mortality. The mediation analysis showed that 32.8% (95% CI 24.9-47.0%) of the relationship between IFE and mortality is mediated through GA. Conclusions IFE is a significant contributor to outcomes in the CCHD population. SGA and placental abruption are the main drivers of postnatal mortality while other maternal placental syndrome components had much less of an impact. Only one third of the effect between IFE and mortality is mediated through GA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.