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The William Harvey Research Institute - Faculty of Medicine and Dentistry

New study sheds light on how and why congenital heart diseases occur in the womb during pregnancy

Researchers find that inflammation in the placenta and specifically inflammatory maternal immune cells impede normal heart development in the developing embryo, impacting the heart tissue’s function in the offspring’s adult life.


Placenta and Embryo heart

New research led by scientists at Queen Mary University of London has found, for the first time, that harmful immune cells called monocytes from the mother are able to cross the placenta and enter the developing heart of the baby, as direct consequence of placental inflammation. Using a pre-clinical model, the researchers discovered that the presence of these harmful maternal cells in the developing heart prevents the organ from developing properly, resulting in congenital heart disease (CHD). They also found that these developmental defects continue into adult life, affecting the normal functions of the heart.

The study, published in the journal Circulation, showed that when the anti-inflammatory agent called anti-TNF-alpha is given to the mother during early pregnancy, where there is an exaggerated placental inflammation, it can rectify the inflammation in the placenta and subsequently allow the heart of the baby to develop properly.

Lead author Dr Suchita Nadkarni from Queen Mary University of London said: “The study sheds light onto how and why congenital heart diseases occur in the womb during pregnancy. Moreover, it provides a tangible therapeutic strategy for treating CHDs in the womb using anti-inflammatory agents, without the need to use complicated and invasive surgery that’s currently used to treat some CHDs.

“Although these studies have been done in animals, they provide a novel insight into how the maternal and placental immune and inflammatory environments can have such profound and long-lasting effects on the baby’s developing heart, which can be translated into the human condition. This is because pregnancy complications that are affected by exaggerated placental inflammation, such as pre-eclampsia (a leading cause of maternal and child mortality and ill-health word-wide), have an increased incidence of babies developing CHDs.”

This study was funded by the British Heart Foundation.

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