The Effect of Size and Asymmetry at Birth on Brain Injury and Neurodevelopmental Outcomes in Congenital Heart Disease.

Autor: Parekh SA; Division of Cardiology, Department of Pediatrics, Benioff Children's Hospital, University of California, Mission Hall Box 0544, 550 16th Street, 5th Floor, San Francisco, CA, 94158, USA., Cox SM; Division of Developmental Pediatrics and Cardiology, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, USA., Barkovich AJ; Department of Radiology, University of California, San Francisco, USA., Chau V; Department of Neurology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada., Steurer MA; Division of Critical Care, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, USA., Xu D; Department of Radiology, University of California, San Francisco, USA., Miller SP; Department of Neurology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada., McQuillen PS; Division of Critical Care, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, USA., Peyvandi S; Division of Cardiology, Department of Pediatrics, Benioff Children's Hospital, University of California, Mission Hall Box 0544, 550 16th Street, 5th Floor, San Francisco, CA, 94158, USA. shabnam.peyvandi@ucsf.edu.
Jazyk: angličtina
Zdroj: Pediatric cardiology [Pediatr Cardiol] 2022 Apr; Vol. 43 (4), pp. 868-877. Date of Electronic Publication: 2021 Dec 01.
DOI: 10.1007/s00246-021-02798-5
Abstrakt: Poor and asymmetric fetal growth have been associated with neonatal brain injury (BI) and worse neurodevelopmental outcomes (NDO) in the growth-restricted population due to placental insufficiency. We tested the hypothesis that postnatal markers of fetal growth (birthweight (BW), head circumference (HC), and head to body symmetry) are associated with preoperative white matter injury (WMI) and NDO in infants with single ventricle physiology (SVP) and d-transposition of great arteries (TGA). 173 term newborns (106 TGA; 67 SVP) at two sites had pre-operative brain MRI to assess for WMI and measures of microstructural brain development. NDO was assessed at 30 months with the Bayley Scale of Infant Development-II (n = 69). We tested the association between growth parameters at birth with the primary outcome of WMI on the pre-operative brain MRI. Secondary outcomes included measures of NDO. Newborns with TGA were more likely to have growth asymmetry with smaller heads relative to weight while SVP newborns were symmetrically small. There was no association between BW, HC or asymmetry and WMI on preoperative brain MRI or with measures of microstructural brain development. Similarly, growth parameters at birth were not associated with NDO at 30 months. In a multivariable model only cardiac lesion and site were associated with NDO. Unlike other high-risk infant populations, postnatal markers of fetal growth including head to body asymmetry that is common in TGA is not associated with brain injury or NDO. Lesion type appears to play a more important role in NDO in CHD.
(© 2021. The Author(s).)
Databáze: MEDLINE
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