MINI REVIEW article
Front. Pediatr.
Sec. Pediatric Surgery
An Overview of the Placenta's Role in the Development of Congenital Diaphragmatic Hernia
Nilhan Torlak 1,2,3,4
Marc Oria 2,5
Braxton Forde 3
Jose Luis Peiro 1,2
Emrah Aydin 2,6
1. Department of Surgery, New York University Grossman School of Medicine, New York, United States
2. Center for Fetal and Placental Research, Cincinnati Children's Hospital Medical Center, Cincinnati, United States
3. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, United States
4. Graduate School of Health Sciences, Koc University, Istanbul, Türkiye
5. Department of Radiation Oncology, University of Cincinnati College of Medicine, Cincinnati, United States
6. Fetal Center, Riley Hospital for Children at Indiana University Health, Indianapolis, United States
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Abstract
Congenital diaphragmatic hernia (CDH) is a severe congenital malformation resulting from incomplete diaphragm development, leading to abdominal organ herniation into the thoracic cavity. This disruption compromises pulmonary development, frequently resulting in pulmonary hypoplasia and hypertension. While the role of the placenta in congenital heart defects is well established, its involvement in congenital lung diseases, particularly CDH, remains unexplored. During the prenatal period, the placenta serves as a crucial site for nutrient and gas exchange between the mother and the fetus, and given its functional connection to fetal development, it provides a compelling avenue for investigating the pathophysiology of CDH. This review synthesizes current knowledge regarding the placental contribution to CDH, with a focus on molecular pathways, particularly the retinoic acid pathway and placental abnormalities. Evidence from both animal models and human studies suggests a complex interplay between placental function and CDH pathogenesis. Further investigation is required to elucidate the placenta's role in disease mechanisms, which may offer perspectives for future research, advances in prenatal diagnostics, and therapeutic strategies.
Summary
Keywords
Congenital Diaphragmatic Hernia, Fetal vascular malperfusion, Placenta, retinoic acidpathway, vasculature
Received
07 January 2026
Accepted
19 February 2026
Copyright
© 2026 Torlak, Oria, Forde, Peiro and Aydin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Nilhan Torlak
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