The synthesis of sphingomyelin from ceramide, via the sphingomyelinase or the hydrolysis pathway, was also shown to be impacted by HF, with a marked decrease in the expression of the gene encoding sphingomyelin synthase 1 (SGMS1: −1.66 ± 0.25, p = 0.006). Here, SGMS1 is linked to hydrops fetalis.