Mette Høj Lauridsen1, Niels Uldbjerg2, Olav Bjørn Petersen2, Else Marie Vestergaard3, Niels Bjerregaard Matthiesen4, Tine Brink Henriksen5, John Rosendahl Østergaard5, Vibeke Elisabeth Hjortdal6. 1. Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark. Electronic address: lauridsen.mette@auh.rm.dk. 2. Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark. 3. Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark. 4. Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark; Pediatrics and Adolescent Medicine, Hospital Unit West, Herning, Denmark. 5. Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark. 6. Cardiothoracic Research Department T, Aarhus University Hospital, Aarhus, Denmark.
Abstract
OBJECTIVES: To estimate the association between fetal congenital heart defects (CHDs) and measures of brain size throughout pregnancy, from the end of the first trimester to birth. STUDY DESIGN: The cohort consisted of all fetuses scanned in Western Denmark in 2012 and 2013. Anthropometric measures in fetuses with isolated CHDs diagnosed within 12 months after birth were compared with those in the fetuses without CHDs. Z-scores standardized to gestational age were calculated for first trimester biparietal diameter, second trimester head circumference, fetal weight, birthweight, head circumference, and placental weight. RESULTS: We obtained data from 63 349 pregnancies and identified 295 fetuses with isolated CHDs (major n = 145; minor n = 150). The first trimester mean biparietal diameter Z-scores were not different between those with and those without CHDs. The head circumference mean Z-score difference was -0.13 (95% CI, -0.24 to -0.01; P = .03) in the second trimester and -0.22 (95% CI, -0.35 to -0.09; P < .001) at birth. Fetuses with univentricular physiology or tetralogy of Fallot showed the most pronounced compromise in cerebral size. CONCLUSIONS: Our results suggest that the brain alterations inducing an increased risk of impaired neurodevelopment in children with CHDs begin during pregnancy. Although fetuses with univentricular physiology or tetralogy of Fallot exhibited the most pronounced compromise in cerebral size, we recommend neurodevelopmental follow-up for all children with CHDs.
OBJECTIVES: To estimate the association between fetal congenital heart defects (CHDs) and measures of brain size throughout pregnancy, from the end of the first trimester to birth. STUDY DESIGN: The cohort consisted of all fetuses scanned in Western Denmark in 2012 and 2013. Anthropometric measures in fetuses with isolated CHDs diagnosed within 12 months after birth were compared with those in the fetuses without CHDs. Z-scores standardized to gestational age were calculated for first trimester biparietal diameter, second trimester head circumference, fetal weight, birthweight, head circumference, and placental weight. RESULTS: We obtained data from 63 349 pregnancies and identified 295 fetuses with isolated CHDs (major n = 145; minor n = 150). The first trimester mean biparietal diameter Z-scores were not different between those with and those without CHDs. The head circumference mean Z-score difference was -0.13 (95% CI, -0.24 to -0.01; P = .03) in the second trimester and -0.22 (95% CI, -0.35 to -0.09; P < .001) at birth. Fetuses with univentricular physiology or tetralogy of Fallot showed the most pronounced compromise in cerebral size. CONCLUSIONS: Our results suggest that the brain alterations inducing an increased risk of impaired neurodevelopment in children with CHDs begin during pregnancy. Although fetuses with univentricular physiology or tetralogy of Fallot exhibited the most pronounced compromise in cerebral size, we recommend neurodevelopmental follow-up for all children with CHDs.
Authors: Camilla Omann; Camilla Nyboe; Rasmus Kristensen; Andreas Ernst; Cecilia Høst Ramlau-Hansen; Charlotte Rask; Ann Tabor; J William Gaynor; Vibeke E Hjortdal Journal: Eur Heart J Open Date: 2022-04-21
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Authors: Louise F Udholm; Anne Gaml-Sørensen; Linn H Arendt; Nis Brix; Lea L H Lunddorf; Andreas Ernst; Ulla B Knudsen; Vibeke E Hjortdal; Cecilia H Ramlau-Hansen Journal: J Am Heart Assoc Date: 2022-03-29 Impact factor: 6.106