Placental and fetal characteristics of the Ohia mouse line recapitulate outcomes in human hypoplastic left heart syndrome

Congenital heart defects (CHDs) are the most common birth defect worldwide. The morbidity and mortality associated with these defects is compounded by increased frequency of fetal growth abnormalities. In the Ohia mouse model of hypoplastic left heart syndrome (HLHS), the double homozygous genotype is embryonically lethal at mid-pregnancy; a time in which optimal establishment of the placenta is crucial to fetal survival. We aimed to characterize placental and fetal growth and development in the double heterozygous genotype ( Sap130 m/+ Pcdha9 m/+ ) to determine whether the genetic mutations associated with HLHS in the Ohia mouse also affect the placenta. The frequency of fetuses with reduced weight near term was shifted in the Sap130 m/+ Pcdha9 m/+ fetuses compared to wildtype. This shift in fetal weight distribution in the Sap130 m/+ Pcdha9 m/+ fetuses was associated with reduced labyrinth region area (P<0.001) and reduced fetal capillary density (P<0.001) in the placentas. Positive correlations were observed between fetal weight and placenta mRNA expression of several nutrient transporters in the Sap130 m/+ Pcdha9 m/+ fetuses but not observed in the wildtype. Increased protein expression of Slc7a5 (P<0.05) and Slc7a8 (P<0.05) was also found in the placenta of Sap130 m/+ Pcdha9 m/+ fetuses. This data shows, despite a potential compensatory mechanism to increase nutrient transport, abhorrent placental vascularization leads to inadequate fetal growth in the Ohia mouse model. Such differences are similar to findings in studies of human placentas and highlights the importance of this mouse model in continuing to understand the developmental links and disruptions to the heart-placenta axis.