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In Reply Dr Brodwell and colleagues express concern that our analysis included infants born preterm and was possibly biased by heart defects related not to preeclampsia but rather to increased surveillance. The premise is that heart defects are more likely to be misdiagnosed in infants born preterm, as the heart is challenging to visualize or has yet to be fully formed at early gestational ages. Because many women with preeclampsia cannot deliver at term, they posit that the analysis should be restricted to critical heart defects, a group unlikely to be overdiagnosed.
Auger N, Fraser WD, Arbour L. Preeclampsia and Congenital Heart Defects—Reply. JAMA. 2016;315(11):1168-1169. doi:10.1001/jama.2015.19084