Mid‐gestation brain Doppler and head biometry in fetuses with congenital heart disease predict abnormal brain development at birth
Abstract
Objectives: Fetuses with congenital heart disease (CHD) show evidence of abnormal brain development before birth, which is thought to contribute to adverse neurodevelopment during childhood. Our aim was to evaluate whether brain development in late pregnancy can be predicted by fetal brain Doppler, head biometry and the clinical form of CHD at the time of diagnosis. Methods: This was a prospective cohort study including 58 fetuses with CHD, diagnosed at 20–24 weeks' gestation, and 58 normal control fetuses. At the time of diagnosis, we recorded fetal head circumference (HC), biparietal diameter, middle cerebral artery pulsatility index (MCA‐PI), cerebroplacental ratio (CPR) and brain perfusion by fractional moving blood volume. We classified cases into one of two clinical types defined by the expected levels (high or low) of placental (well‐oxygenated) blood perfusion, according to the anatomical defect. All fetuses underwent subsequent 3T‐magnetic resonance imaging (MRI) at 36–38 weeks' gestation. Results: Abnormal prenatal brain development was defined by a composite score including any of the following findings on MRI: total brain volume < 10 th centile, parietoccipital or cingulate fissure depth < 10 th centile or abnormal metabolic profile in the frontal lobe. Logistic regression analysis demonstrated that MCA‐PI (odds ratio (OR), 12.7; P = 0.01), CPR (OR, 8.7; P = 0.02) and HC (OR, 6.2; P = 0.02) were independent predictors of abnormal neurodevelopment; however, the clinical type of CHD was not. Conclusions: Fetal brain Doppler and head biometry at the time of CHD diagnosis are independent predictors of abnormal brain development at birth, and could be used in future algorithms to improve counseling and targeted interventions. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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All studies of fetal and neonatal brain volumes show significant reductions in total brain volume, white matter, and cortical gray matter in congenital heart disease compared with controls.
“All studies of fetal and neonatal brain volumes (Table I) show significant reductions in total brain volume, white matter, and cortical gray matter (CGM) in CHD when compared with controls.28,30,33,34”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [33]
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- Authors
- Masoller, N., Sanz‐Cortés, M., Crispi, F., Gómez, O., Bennasar, M., Egaña‐Ugrinovic, G., Bargalló, N., Martínez, J. M., & Gratacós, E.
- Affiliations
- Hospital Sant Joan de Déu Barcelona (ES)
- BCNatal – Barcelona Center for Maternal–Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), IDIBAPS University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER‐ER) Barcelona Spain
- Hospital Clínic de Barcelona (ES)
- Corresponding author
- Masoller, N.
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2016-01
- Volume
- 47
- Issue
- 1
- Pages
- 65-73
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W2397467584
- Cited by
- 84
- References
- 46
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 4 · 2023: 4 · 2022: 10 · 2021: 9 · 2020: 8 · 2019: 8 · 2018: 7 · 2017: 14 · 2016: 9 · 2013: 1
- FWCI
- 7.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- “la Caixa” Foundation
- Cerebra
- Instituto de Salud Carlos III
- European Regional Development Fund
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Keywords
- congenital heart disease, fetal brain development, middle cerebral artery pulsatility index, cerebroplacental ratio, fetal head circumference, fetal brain MRI
- MeSH terms
- Adult, Brain, Cephalometry, Echocardiography, Echoencephalography, Female, Head, Heart Defects, Congenital, Humans, Magnetic Resonance Imaging, Nervous System Malformations, Pregnancy, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Prospective Studies, Pulsatile Flow, Cohort Studies, Logistic Models, Ultrasonography, Prenatal, Ultrasonography, Doppler, Transcranial, Middle Cerebral Artery
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