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Head circumference in neonates with septal defects
Line Høffner1,2, Anna Maria Dehn1,2, Sofie Dannesbo3,2,4
1Department of Cardiothoracic Surgery, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Insights
Neonates with septal defects, such as atrial or ventricular septal defects, do not show differences in head circumference at birth compared to infants without these heart conditions. This finding is important for understanding early development in infants with congenital heart disease.
Area of Science:
- Pediatric Cardiology
- Neonatal Research
- Developmental Pediatrics
Background:
- Congenital heart defects (CHD) affect up to 50% of children, often leading to neurodevelopmental issues.
- Small head circumference at birth is linked to impaired neurodevelopment in complex CHD.
- The impact of simple septal defects on head circumference is not well understood.
Purpose of the Study:
- To investigate and compare head circumference at birth in neonates with atrial or ventricular septal defects versus controls.
- To determine if simple septal defects are associated with smaller head circumferences at birth.
Main Methods:
- Prospective, population-based cohort study of over 25,000 neonates (Copenhagen Baby Heart Study).
- Transthoracic echocardiography within 30 days of birth to identify atrial or ventricular septal defects.
- Comparison of head circumference in term neonates with septal defects to matched controls without septal defects.
Main Results:
- Neonates with septal defects (n=1,030) had a mean head circumference of 34.8 cm.
- Controls without septal defects (n=5,150) had a mean head circumference of 34.7 cm (p=0.07).
- No significant differences in mean head circumference z-scores were observed between groups (p=0.07).
Conclusions:
- Head circumference at birth does not differ between term neonates with septal defects and those without.
- Simple septal defects are not associated with smaller head circumferences at birth.
Background:
Neurodevelopmental disorders occur in up to 50% of children with CHD. Small head circumference at birth has been associated with impaired neurodevelopment in patients with complex CHD. It is unknown if patients with simple CHD such as septal defects have smaller head circumferences. The objective of this study was to investigate the head circumference at birth in neonates with either an atrial or a ventricular septal defect.
Methods:
This study is part of the Copenhagen Baby Heart Study; a prospective, population-based cohort study of more than 25,000 neonates. The neonates were examined with a comprehensive transthoracic echocardiography within the first 30 days of birth including assessment for atrial or ventricular septal defects. The head circumference at birth in term neonates with septal defects was compared to the head circumference in matched controls, term neonates without septal defects from the same birth cohort.
Results:
Neonates with septal defects (n = 1,030; 45.2% male; mean birthweight 3,534g ± 483g) had a mean head circumference of 34.8 cm (95% confidence interval 34.7-34.9 cm), compared to neonates without septal defects (n = 5,150; 45.6% male; mean birthweight 3,546g ± 476g) of 34.7 cm (95% confidence interval 34.7-34.8 cm); p-value 0.07. Mean calculated z-score of head circumferences was 0.05 for neonates with septal defects and -0.01 for neonates without septal defects, p = 0.07. Dividing cases into neonates with atrial septal defects, ventricular septal defects, and those without septal defects did not show differences between groups, p = 0.14.
Conclusion:
The head circumference in term neonates with septal defects did not differ from matched controls without septal defects.
