OBJECTIVE: We sought to ascertain the risk of reduced fetal brain growth in cases of isolated congenital heart defect (CHD) based on microcephaly at birth. STUDY DESIGN: In a case-control study, head circumference was compared in 401 newborns with isolated CHD with 401 control subjects. Microcephaly was defined as head circumference below third percentile. The rates of microcephaly in multiple different categories of major CHD were ascertained along with logistic regression analyses to determine the specific types of cardiac defects that were significantly associated with microcephaly. RESULTS: Isolated CHD in the fetus was associated with an increased risk of microcephaly as were tetralogy of Fallot, coarctation/aortic arch hypoplasia, and hypoplastic left ventricle syndrome. Tetralogy of Fallot odds ratio, 2.6; 95% confidence interval, 1.1-6.3; P < .04 and coarctation/aortic arch hypoplasia, odds ratio, 2.8; 95% confidence interval, 1.5-5.1; P < .001 were significant independent predictors of microcephaly. CONCLUSION: The finding of microcephaly at birth in nonsyndromic CHD provides strong evidence in support of intrauterine hypoxic central nervous system damage. Potential changes in prenatal management including aggressive antepartum surveillance and earlier delivery warrant urgent consideration.
OBJECTIVE: We sought to ascertain the risk of reduced fetal brain growth in cases of isolated congenital heart defect (CHD) based on microcephaly at birth. STUDY DESIGN: In a case-control study, head circumference was compared in 401 newborns with isolated CHD with 401 control subjects. Microcephaly was defined as head circumference below third percentile. The rates of microcephaly in multiple different categories of major CHD were ascertained along with logistic regression analyses to determine the specific types of cardiac defects that were significantly associated with microcephaly. RESULTS: Isolated CHD in the fetus was associated with an increased risk of microcephaly as were tetralogy of Fallot, coarctation/aortic arch hypoplasia, and hypoplastic left ventricle syndrome. Tetralogy of Fallot odds ratio, 2.6; 95% confidence interval, 1.1-6.3; P < .04 and coarctation/aortic arch hypoplasia, odds ratio, 2.8; 95% confidence interval, 1.5-5.1; P < .001 were significant independent predictors of microcephaly. CONCLUSION: The finding of microcephaly at birth in nonsyndromic CHD provides strong evidence in support of intrauterine hypoxic central nervous system damage. Potential changes in prenatal management including aggressive antepartum surveillance and earlier delivery warrant urgent consideration.
Authors: Amy H Schultz; Richard F Ittenbach; Marsha Gerdes; Gail P Jarvik; Gil Wernovsky; Judy Bernbaum; Cynthia Solot; Robert R Clancy; Susan C Nicolson; Thomas L Spray; Donna McDonald-McGinn; Elaine Zackai; J William Gaynor Journal: J Thorac Cardiovasc Surg Date: 2017-02-21 Impact factor: 5.209
Authors: Nadja Schönberg; Christian Weisstanner; Roland Wiest; Harald M Bonél; Eike I Piechowiak; Jennifer L Cullmann; Luigi Raio; Manuela Pastore-Wapp; Nedelina Slavova Journal: J Neuroimaging Date: 2020-06-17 Impact factor: 2.486
Authors: A E L van Nisselrooij; F A R Jansen; N van Geloven; I H Linskens; E Pajkrt; S-A Clur; L A Rammeloo; L Rozendaal; J M M van Lith; N A Blom; M C Haak Journal: Ultrasound Obstet Gynecol Date: 2019-12-27 Impact factor: 7.299