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Congenital Heart Defects and Measures of Prenatal Brain Growth: A Systematic Review
Thommy Hansen1, Tine Brink Henriksen2, Cathrine Carlsen Bach2
1Perinatal Epidemiology Research Unit, Aarhus University Hospital, Aarhus, Denmark; Department of Medicine, Silkeborg Regional Hospital, Silkeborg, Denmark.
Insights
Congenital heart defects are linked to reduced prenatal brain growth, impacting neurodevelopment. Further research is needed to confirm this association and address confounding factors in large-scale studies.
Area of Science:
- Developmental biology
- Pediatric cardiology
- Neuroscience
Background:
- Congenital heart defects (CHDs) are common birth malformations affecting ~6/1000 live births.
- CHDs are associated with long-term neurodevelopmental disorders.
- Emerging evidence links impaired prenatal brain growth to neurodevelopmental issues in children with CHDs.
Purpose of the Study:
- To systematically review evidence on the association between congenital heart defects and prenatal brain growth.
- To identify specific CHDs with the strongest evidence of association with impaired brain growth.
Main Methods:
- Systematic literature searches conducted in PubMed and EMBASE.
- Included original studies comparing fetuses/newborns with CHDs to controls regarding brain biometrics (biparietal diameter, brain volume, head circumference).
- Extracted and presented study characteristics and results; no meta-analysis performed.
Main Results:
- Twenty-eight studies were included in the review.
- A significant association between CHDs and reduced prenatal brain growth was found in all but two studies.
- Strongest evidence for this association was observed in hypoplastic left heart syndrome, tetralogy of Fallot, and transposition of the great arteries.
Conclusions:
- The reviewed literature suggests an association between CHDs and impaired prenatal brain growth.
- Most included studies were small and lacked control for confounding factors or bias.
- Future large-scale studies are warranted to address confounders and strengthen evidence.
Background:
We summarize the evidence for an association between congenital heart defects and prenatal brain growth through a systematic literature review. Congenital heart defects are among the most common malformations, affecting approximately six per 1000 live births. The association between congenital heart defects and long-term neurodevelopmental disorders is well established. Increasing evidence suggests an association between impaired prenatal brain growth and neurodevelopmental disorders in children with congenital heart defects.
Methods:
Systematic literature searches were performed in PubMed and EMBASE. We included original studies comparing fetuses or newborns with congenital heart defects to reference fetuses or newborns with respect to brain biometrics, including biparietal diameter, brain volume, and head circumference at birth. The study characteristics and the results were extracted and presented in tables. No meta-analysis was undertaken.
Results:
Twenty-eight studies were included. All except two studies found an association between congenital heart defects and measures of reduced prenatal brain growth. The strongest evidence concerned hypoplastic left heart syndrome, tetralogy of Fallot, and transposition of the great arteries.
Conclusions:
The literature suggests an association between congenital heart defects and measures of impaired prenatal brain growth. However, most studies were small and failed to include important potential confounding factors and to address other sources of potential bias as well. Future large-scale studies that address potential confounders are warranted.
