Association of Isolated Congenital Heart Disease with Fetal Brain Maturation
- 1 August 2020
- journal article
- research article
- Published by American Society of Neuroradiology (ASNR) in American Journal of Neuroradiology
- Vol. 41 (8), 1525-1531
- https://doi.org/10.3174/ajnr.A6635
Abstract
BACKGROUND AND PURPOSE: Brain MRI of newborns with congenital heart disease show signs of immaturity relative to healthy controls. Our aim was to determine whether the semiquantitative fetal total maturation score can detect abnormalities in brain maturation in fetuses with congenital heart disease in the second and third trimesters. MATERIALS AND METHODS: We analyzed data from a prospective study of fetuses with and without congenital heart disease who underwent fetal MR imaging at 25-35 weeks' gestation. Two independent neuroradiologists blinded to the clinical data reviewed and scored all images using the fetal total maturation score. Interrater reliability was evaluated by the intraclass correlation coefficient using the individual reader scores, which were also used to calculate an average score for each subject. Comparisons of the average and individual reader scores between affected and control fetuses and relationships with clinical variables were evaluated using multivariable linear regression. RESULTS: Data from 69 subjects (48 cardiac, 21 controls) were included. High concordance was observed between readers with an intraclass correlation coefficient of 0.98 (95% CI, 0.97-0.99). The affected group had significantly lower fetal total maturation scores than the control group (beta-estimate, -0.9 [95% CI, -1.5 to -0.4],P= .002), adjusting for gestational age and sex. Averaged fetal total maturation, germinal matrix, myelination, and superior temporal sulcus scores were significantly delayed in fetuses with congenital heart disease versus controls (P < .05 for each). The fetal total maturation score was not significantly associated with any cardiac, anatomic, or physiologic variables. CONCLUSIONS: The fetal total maturation score is sensitive to differences in brain maturation between fetuses with isolated congenital heart disease and healthy controls.Funding Information
- National Institute of Neurological Disorders and Stroke (K23NS101120)
- American Academy of Neurology (Clinical Research Training Fellowship)
- Society for Pediatric Radiology (Young Investigator Award)
- Boston Children’s Hospital (Office of Faculty Development, Career Development)
- National Heart, Lung, and Blood Institute (Pediatric Heart Network Scholar Award)
- National Institute of Biomedical Imaging and Bioengineering (R01EB013248, R01EB018988)
- Mend a Heart Foundation
- Brain and Behavior Research Foundation (Distinguished Investigator, NARSAD Young Investigator)
- Schlaeger Fellowship for Neuroscience Research (Young Investigator Award)
- McKnight Foundation Technological Innovations in Neuroscience Award
This publication has 31 references indexed in Scilit:
- Probabilistic tractography-based thalamic parcellation in healthy newborns and newborns with congenital heart diseaseJournal of Magnetic Resonance Imaging, 2017
- Brain in Congenital Heart Disease Across the LifespanCirculation, 2016
- De novo mutations in congenital heart disease with neurodevelopmental and other congenital anomaliesScience, 2015
- Lifetime Prevalence of Congenital Heart Disease in the General Population From 2000 to 2010Circulation, 2014
- Brain Volume and Neurobehavior in Newborns with Complex Congenital Heart DefectsThe Journal of Pediatrics, 2013
- Adolescents With d-Transposition of the Great Arteries Corrected With the Arterial Switch ProcedureCirculation, 2011
- Abnormal Brain Development in Newborns with Congenital Heart DiseaseThe New England Journal of Medicine, 2007
- Neurodevelopmental status at eight years in children with dextro-transposition of the great arteries: The Boston Circulatory Arrest TrialThe Journal of Thoracic and Cardiovascular Surgery, 2003
- Predictors of developmental disabilities after open heart surgery in young children with congenital heart defectsThe Journal of Pediatrics, 2002
- Vulnerability of Developing Brain: Relative Effects of Growth Restriction during the Fetal and Suckling Periods on Behavior and Brain Composition of Adult RatsJournal of Nutrition, 1973