Serial neurosonography in fetuses with congenital heart defects shows mild delays in cortical development. (19th September 2021)

• Record Type: Journal Article
• Authors: Everwijn, Sheila M.; van Bohemen, Jiska F.; van Geloven, Nan; Jansen, Fenna A.; Teunissen, Aalbertine K.; Rozendaal, Lieke; Blom, Nico; van Lith, Jan M.; Haak, Monique C.
• Is Part Of: Prenatal diagnosis. Volume 41:Number 13(2021)
• Page Start: 1649
• Page End: 1657
• Publication Date: 2021-09-19
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.6038
• Languages: English
• ISSNs: 0197-3851

Abstract

Abstract: Introduction: Neurodevelopmental delay is more common in children born with congenital heart defects (CHD), even with optimal perinatal and peri‐operative care. It is hypothesized that fetuses with CHD are prone to neurological impairment in utero due to their cardiac defect, possibly leading to delayed cortical development. Methods: Cerebral cortical maturation was assessed with advanced neurosonographic examinations every 4 weeks in fetuses with CHD and compared to control fetuses. Five different primary fissures and four areas were scored (ranging 0–5) by blinded examiners using a cortical maturation scheme. Results: Cortical staging was assessed in 574 ultrasound examinations in 85 CHD fetuses and 61 controls. Small differences in grading were seen in Sylvian and cingulate fissures. (Sylvian fissure: −0.12 grade, 95% CI (−0.23; −0.01) p = 0.05, cingulate fissure: −0.24 grade, 95% CI (−0.38; −0.10) p = <0.001. Other cortical areas showed normal maturation as compared to control fetuses. Conclusion: Small differences were seen in three of the nine analyzed cortical areas in CHD fetuses, in contrast to previous reports on progressive third‐trimester delay. The clinical implications of the small differences however, remain unknown. Key points: What is already known about this topic? Neurodevelopmental delay is more prevalent in children with congenital heart defects Intrauterine hemodynamics are hypothesized to play a role in fetal cerebral abnormalities found in imaging studies What does this study add? Delays were seen in the Sylvian, cingulate and calcarine fissures by serial neurosonography The differences we found were stable throughout pregnancy, contradicting previous studies on progressive delay over time