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Prenatal markers of atypical neurodevelopment in children with congenital heart defects

Laurence S Carmant1, Isabelle Boucoiran1, Mélodie Mathe1

  • 1Department of Obstetrics and Gynecology, CHU Sainte-Justine, Université de Montréal, Montreal, Canada.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|April 13, 2021
PubMed

Insights

Congenital heart defect (CHD) survivors often experience early neurodevelopmental delays. A head-to-abdominal circumference ratio below 1.1 on prenatal ultrasound can indicate a higher risk for atypical neurodevelopment in infants with CHD.

Area of Science:

  • Pediatric Cardiology
  • Neurodevelopmental Pediatrics
  • Prenatal Diagnostics

Background:

  • Congenital heart defects (CHD) survivors face increased risks of neurodevelopmental delays, particularly motor delays in infancy.
  • Early identification of neurodevelopmental issues is crucial for timely intervention and improved outcomes.

Purpose of the Study:

  • To identify prenatal predictors of early atypical neurodevelopment in infants with CHD.
  • To aid in prenatal counseling by providing data on risk factors.

Main Methods:

  • Retrospective cohort study of 75 infants with CHD.
  • Neurodevelopmental outcome assessed using the Alberta Infant Motor Scale (AIMS) at 4 months.
  • Bivariate and multivariate analyses to correlate prenatal factors with atypical neurodevelopment (AIMS < 10th percentile).

Main Results:

  • 58.7% of infants exhibited atypical neurodevelopment.
  • A head-to-abdominal circumference ratio (HC/AC) below 1.1 was associated with a four-fold increased risk of atypical neurodevelopment (OR = 4.54) in the absence of other cardiac anomalies.
  • A trend suggested more extra cardiac anomalies in infants with atypical neurodevelopment (27.3%) compared to typical (9.7%).

Conclusions:

  • Early atypical neurodevelopment is prevalent in the majority of CHD infants.
  • Prenatal ultrasound screening for extra cardiac anomalies and an HC/AC ratio below 1.1 can identify high-risk infants.
  • Post-natal monitoring by specialized teams is essential for CHD survivors.
Abstract

Keywords:
Congenital heart defectsneurodevelopmental outcomesprenatal markers

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