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Relationship between fetal brain development and congenital diaphragmatic hernia

Charline Bradshaw1, Alena Uus2, Jordina Aviles Verdera2

  • 1Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom; Institute of Women and Children's Health, School of Life Course and Population Sciences, King's College London, United Kingdom.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|December 7, 2025
PubMed

Insights

Congenital diaphragmatic hernia (CDH) can impact fetal brain development before birth. This review highlights brain volume reductions and altered development in CDH fetuses, suggesting early antenatal origins.

Area of Science:

  • Developmental Biology
  • Neonatal Neurology
  • Fetal Medicine

Background:

  • Congenital diaphragmatic hernia (CDH) is a severe fetal anomaly.
  • It is primarily linked to lung development issues (pulmonary hypoplasia) and high blood pressure in the lungs (persistent pulmonary hypertension).
  • Growing evidence indicates that neurodevelopmental problems in CDH may start before birth.

Purpose of the Study:

  • To review current literature on antenatal brain alterations in fetuses with CDH.
  • To explore the potential mechanisms contributing to these brain changes.
  • To inform future prognostication and management strategies for CDH.

Main Methods:

  • Review of existing scientific literature on fetal brain development in CDH.
  • Analysis of studies using fetal Magnetic Resonance Imaging (MRI) and Ultrasound-Doppler.
  • Inclusion of findings from animal models of CDH.

Main Results:

  • Fetal brain alterations in CDH include reduced brain volume in specific regions.
  • Disrupted cortical architecture and altered cerebral blood flow are observed.
  • Animal models suggest hypoxia, poor vascularization, and inflammation play roles.

Conclusions:

  • Neurodevelopmental impairment in CDH likely has an antenatal origin.
  • A multifactorial pathogenesis involving hemodynamic and inflammatory factors is supported.
  • Understanding these early brain changes is crucial for optimizing CDH care.

Keywords:
Congenital diaphragmatic herniaMagnetic resonance imagingNeurodevelopmentUltrasound

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