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Fetal Heart Defects and Measures of Cerebral Size

Mette Høj Lauridsen1, Niels Uldbjerg2, Olav Bjørn Petersen2

  • 1Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.

The Journal of Pediatrics
|April 10, 2019
PubMed

Insights

Fetal brain size may be reduced in pregnancies with congenital heart defects (CHDs), indicating early developmental alterations. Neurodevelopmental follow-up is recommended for all infants with CHDs.

Area of Science:

  • Perinatology
  • Fetal Medicine
  • Pediatric Cardiology

Background:

  • Congenital heart defects (CHDs) are common birth anomalies.
  • Early detection and understanding of associated conditions are crucial for improved outcomes.

Purpose of the Study:

  • To investigate the association between fetal congenital heart defects (CHDs) and brain size measurements during pregnancy.
  • To determine if brain size differences are detectable from the first trimester onwards.

Main Methods:

  • A cohort study of 63,349 pregnancies in Western Denmark (2012-2013).
  • Comparison of anthropometric measures (Z-scores) in fetuses with isolated CHDs versus controls.
  • Analysis included biparietal diameter, head circumference, fetal weight, birthweight, and placental weight.

Main Results:

  • No significant difference in first-trimester biparietal diameter Z-scores between groups.
  • A statistically significant reduction in head circumference Z-scores was observed in the second trimester (-0.13) and at birth (-0.22) for fetuses with CHDs.
  • Fetuses with univentricular physiology or tetralogy of Fallot showed the most significant reduction in cerebral size.

Conclusions:

  • Brain alterations associated with CHDs appear to begin during pregnancy.
  • The findings support the need for neurodevelopmental follow-up for all children diagnosed with CHDs.
  • Specific CHDs, like univentricular physiology and tetralogy of Fallot, are linked to more pronounced cerebral size compromise.
Abstract

Keywords:
CHDcongenital heart defectsfetal growthfetal neurodevelopmentfollow-uphead circumferenceneurodevelopmentpregnancy

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