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A Pipeline to Characterize Structural Heart Defects in the Fetal Mouse
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Brain maturation is delayed in infants with complex congenital heart defects

Daniel J Licht1, David M Shera, Robert R Clancy

  • 1Divison of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. licht@email.chop.edu

The Journal of Thoracic and Cardiovascular Surgery
|March 5, 2009
PubMed

Insights

Congenital heart defects in newborns are linked to delayed brain development, resulting in smaller head circumferences and immature brain structures. This prenatal delay may increase the risk of brain injury in infants.

Area of Science:

  • Neonatal neurology
  • Pediatric cardiology
  • Developmental neuroscience

Background:

  • Infants with severe congenital heart defects (CHDs) often exhibit smaller head circumferences and periventricular leukomalacia.
  • CHDs can significantly impact fetal development, including the central nervous system.

Purpose of the Study:

  • To test the hypothesis that CHDs cause delays in fetal brain development.
  • To investigate the relationship between specific CHDs and in utero brain maturation.

Main Methods:

  • Prospective evaluation of term infants with hypoplastic left heart syndrome (HLHS) or transposition of the great arteries (TGA) using preoperative brain MRI.
  • Exclusion of infants with confounding factors like shock or intrauterine growth retardation.
  • Assessment of head circumference and total maturation score (TMS) on MRI to quantify brain development.

Main Results:

  • The study included 29 neonates with HLHS and 13 with TGA.
  • Infants with CHDs had head circumferences 1 standard deviation below normal.
  • The mean TMS was significantly lower than normative data, indicating a 1-month delay in structural brain development.

Conclusions:

  • Term infants with HLHS and TGA demonstrate smaller and structurally less mature brains prior to surgical intervention.
  • This prenatal delay in brain development may predispose these infants to periventricular leukomalacia.
  • Early identification of developmental delays is crucial for managing infants with CHDs.
Abstract

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