Linking the Perinatal Environment to Neonatal Cardiovascular Outcomes

Abstract

Cases of high-risk pregnancies continue to rise throughout the United States and globally, increasing rates of maternal and neonatal morbidity. Common pregnancy complications and morbidities include preterm birth, hypertensive disorders, fetal growth restriction, diabetes mellitus, and chorioamnionitis. Exposure to these perinatal conditions contributes to cardiac morbidities in the fetus and neonate, including altered cardiac growth, congenital heart disease, and cardiac dysfunction. Significant research has demonstrated lasting effects of these pregnancy complications, with increased rates of cardiac morbidities seen in children and adults after these perinatal exposures. The link between the perinatal environment and long-term outcomes has not been fully elucidated. The aim of this review is to discuss the current understanding of the implications of a high-risk pregnancy on fetal and neonatal cardiac development.

Fertility treatment increases the risk of preterm birth independent of multiple gestations

“…Several factors associated with ART are known to predispose to preterm birth, such as the high incidence of multiple gestational pregnancies and maternal comorbidities that include gestational diabetes and hypertensive disorders of pregnancy ( 2 , 6 , 17 , 18 , 19 ). It has been postulated that these maternal conditions are an expression of an adverse maternal-fetal environment (AMFE) ( 20 , 21 , 22 , 23 ). Although it has been shown that the increasing adoption of single embryo transfer led to a decrease in multiple gestation, the effect of multiple gestation and AMFE on the increased rates of prematurity in neonates conceived with the help of NIFT or ART has never been quantified.…”