The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index; none of the 30 sources its claims cite is checked for support yet.
Brain Volume and Metabolism in Fetuses With Congenital Heart Disease: Evaluation With Quantitative Magnetic Resonance Imaging and Spectroscopy
Open accessAbstract
BACKGROUND: Adverse neurodevelopmental outcome is an important source of morbidity in children with congenital heart disease (CHD). A significant proportion of newborns with complex CHD have abnormalities of brain size, structure, or function, which suggests that antenatal factors may contribute to childhood neurodevelopmental morbidity. METHODS AND RESULTS: Brain volume and metabolism were compared prospectively between 55 fetuses with CHD and 50 normal fetuses with the use of 3-dimensinal volumetric magnetic resonance imaging and proton magnetic resonance spectroscopy. Fetal intracranial cavity volume, cerebrospinal fluid volume, and total brain volume were measured by manual segmentation. Proton magnetic resonance spectroscopy was used to measure the cerebral N-acetyl aspartate: choline ratio (NAA:choline) and identify cerebral lactate. Complete fetal echocardiograms were performed. Gestational age at magnetic resonance imaging ranged from 25 1/7 to 37 1/7 weeks (median, 30 weeks). During the third trimester, there were progressive and significant declines in gestational age-adjusted total brain volume and intracranial cavity volume in CHD fetuses relative to controls. NAA:choline increased progressively over the third trimester in normal fetuses, but the rate of rise was significantly slower (P<0.001) in CHD fetuses. On multivariable analysis adjusted for gestational age and weight percentile, cardiac diagnosis and percentage of combined ventricular output through the aortic valve were independently associated with total brain volume. Independent predictors of lower NAA:choline included diagnosis, absence of antegrade aortic arch flow, and evidence of cerebral lactate (P<0.001). CONCLUSIONS: Third-trimester fetuses with some forms of CHD have smaller gestational age- and weight-adjusted total brain volumes than normal fetuses and evidence of impaired neuroaxonal development and metabolism. Hemodynamic factors may play an important role in this abnormal development.
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“No control fetuses had detectable cerebral lactate.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cerebral lactate was detected in 7 of 36 (20%) fetuses with CHD (5 with HLHS, 2 with TGA) between 29 3/7 and 35 5/7 weeks GA.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On multivariable analysis adjusting for both GA and TBV (a stronger correlate of NAA:Cho than GA), independent predictors of lower NAA:Cho included diagnostic category (HLHS, TGA or pulmonary atresia, other CHD or control; p<0.001), absence of antegrade flow in the aortic arch (p=0.01), and the presence of lactate (p<0.001) (model R2=0.90).”
- Also stated in: § Methods and Results · plain
“Independent predictors of lower NAA:Cho included diagnosis, absence of antegrade aortic arch flow, and evidence of cerebral lactate (p<0.001).”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Methods and Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no clear difference in TBV between the 6 CHD fetuses with mild abnormalities on conventional MRI and those without.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In a multivariable model adjusted for GA and weight percentile, a lower percentage of combined ventricular output from the aorta (p<0.001) and diagnostic category (p<0.001) were independently associated with smaller TBV (model R2=0.94).”
- Also stated in: § Methods and Results · plain
“On multivariable analysis adjusting for GA and weight percentile, cardiac diagnosis and percentage of combined ventricular output through the aortic valve were independently associated with TBV.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Methods and Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The NAA:Cho ratio increased progressively over the third trimester in controls, from ∼0.1 at 25 weeks to ∼0.8 at 36 weeks (R2=0.94, p<0.001, Figure 5).”
- Also stated in: § Methods and Results · plain
“NAA:Cho increased progressively over the third trimester in normal fetuses, but the rate of rise was significantly slower (p<0.001) in CHD fetuses.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Methods and Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared with controls, NAA:Cho in CHD fetuses was significantly and progressively lower with advancing GA (p<0.001) (Figure 5).”
- Also stated in: § Methods and Results · plain
“NAA:Cho increased progressively over the third trimester in normal fetuses, but the rate of rise was significantly slower (p<0.001) in CHD fetuses.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Methods and Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Similarly, on adjusted multivariable analysis, CHD category was independently associated with the CSF:ICV ratio, with the highest ratios in HLHS and the lowest in fetuses with no CHD or other CHD (p<0.001, model R2=0.85).”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On multivariable analysis adjusting for both GA and TBV (a stronger correlate of NAA:Cho than GA), independent predictors of lower NAA:Cho included diagnostic category (HLHS, TGA or pulmonary atresia, other CHD or control; p<0.001), absence of antegrade flow in the aortic arch (p=0.01), and the presence of lactate (p<0.001) (model R2=0.90).”
- Also stated in: § Methods and Results · plain
“Independent predictors of lower NAA:Cho included diagnosis, absence of antegrade aortic arch flow, and evidence of cerebral lactate (p<0.001).”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Methods and Results · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On multivariable analysis adjusting for both GA and TBV (a stronger correlate of NAA:Cho than GA), independent predictors of lower NAA:Cho included diagnostic category (HLHS, TGA or pulmonary atresia, other CHD or control; p<0.001), absence of antegrade flow in the aortic arch (p=0.01), and the presence of lactate (p<0.001) (model R2=0.90).”
- Also stated in: § Methods and Results · plain
“Independent predictors of lower NAA:Cho included diagnosis, absence of antegrade aortic arch flow, and evidence of cerebral lactate (p<0.001).”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Methods and Results · plain
- It may state two separate claims as one. 17
- Borderline: one of the tests for a substantial claim is unclear. 1
- Probably not a substantial claim. 8
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At 25 weeks gestation, TBV and ICV were similar in CHD fetuses and controls (i.e., the 25-week Y-intercept of the control and CHD regression equations did not differ).”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cho:Cr generally declined over gestation in control (quadratic R2=0.47) and CHD (R2=0.23) fetuses, with relatively weak correlation with GA in both groups.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“CSF (R2=0.80, p<0.001) and the proportion of ICV occupied by CSF (CSF:ICV, R2=0.93, p<0.001) decreased with increasing GA (Figure 4).”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no difference in Cho:Cr between cases and controls, and no predictors of Cho:Cr were identified.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Complete volumetric MRI analysis was possible in all 105 fetuses.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Tests? Asserted: unclear✓ Checkable: passes? Load-bearing: unclear? Based: unclearBorderline substantial claim. It is unclear whether the authors put it forward as true. It is unclear whether the paper’s conclusions depend on it. It is unclear why the paper says it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Third-trimester fetuses with some forms of CHD have smaller GA- and weight-adjusted TBV than normal fetuses, and evidence of impaired neuroaxonal development and metabolism.”
- Also stated in: § Conclusions · plain
“Brain volume and metabolism are abnormal in third-trimester fetuses with some forms of complex CHD, particularly those with HLHS or TGA, and reduced flow through the systemic ventricle or antegrade around the aortic arch.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Abstract > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Conclusions · plain
None of the sources cited for this claim have been checked yet.
In the paper
“However, there is increasing evidence that adverse neurodevelopmental outcomes in children with complex CHD are due not only perioperative insult, but to inborn factors as well.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Introduction
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Reports from a number of investigators have documented a high prevalence of anatomic and functional neurologic abnormalities prior to surgery in newborns with CHD [9-17], and an association of such abnormalities with childhood developmental status [11,13,18,19].”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Introduction
What the sources say
- Not checked yetcites [9] source
- Not checked yetcites [10] source
- Not checked yetcites [11] source
- Not checked yetcites [12] source
- Not checked yetcites [13] source
- Not checked yetcites [14] source
- Not checked yetcites [15] source
- Not checked yetcites [16] source
- Not checked yetcites [17] source
- Not checked yetcites [18] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Cerebral lactate, a marker of anaerobic metabolism in the newborn and fetus [38,39], has been found in up to 50% of preoperative infants with CHD [14,15] and is associated with adverse outcome in other high-risk infants [40].”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Discussion > Quantitative MRI and MRS in the Evaluation of Brain Development
What the sources say
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“NAA increases with GA and decreases with brain injury [24], and reflects not only the development of dendrites and synapses but also oligodendrocyte proliferation and differentiation [36].”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Discussion > Quantitative MRI and MRS in the Evaluation of Brain Development
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, we did not measure serial fetal brain volumes and therefore could not truly assess growth.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Discussion > Limitations
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Intra-observer correlation coefficients were determined for measurements of ICV (n=481), TBV (n=458), and CSF (n=481) on all individual slices from 10 MRI studies, and were ≥0.997 in all cases.”
- Also stated in: § Fetal Brain MRI · plain
“Intra-observer correlation coefficients were also determined for the summed volumes ICV, TBV, and CSF from 15 MRI scans, and were 0.98 for ICV, 0.96 for TBV, and 0.95 for CSF.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Methods > Fetal Brain MRI
Strength:plain· not yet calibratedn = 481Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Fetal Brain MRI · plain
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Although we attempted to exclude fetuses with genetic and/or cerebral dysgenetic conditions, undiagnosed or as yet unknown genetic conditions may have been missed. Such anomalies may be more common in subjects with CHD than in controls, potentially introducing bias.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Discussion > Limitations
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because MRI studies in control fetuses were typically obtained later in gestation than echocardiograms, echocardiographic data were not included as predictor variables in analyses that included control fetuses, although adjustment was performed using weight percentiles derived from ultrasound estimates of fetal weight.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Methods > Statistical Analysis
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All measurements were made by a single operator (CL) who was blinded to clinical data.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Methods > Fetal Brain MRI
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Cho:Cr and NAA:Cho ratios were calculated when MR spectra satisfied a reliable fit with a standard deviation <20% for each metabolite [27].”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Methods > Fetal Brain MRI
What the sources say
- Not checked yetcites [27] source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A total of 116 fetuses were enrolled, but 11 were excluded due to excessive fetal motion resulting in inadequate MRI data (n=8), brain dysgenesis (inferior vermian hypoplasia) detected by fetal MRI (n=2, both with CHD), and maternal claustrophobia preventing completion of the MRI (n=1).”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Subjects
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Written informed consent from mothers was obtained according to a protocol approved by the Children's Hospital Committee for Clinical Investigation.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Methods > Subjects
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Fetal MRI studies were analyzed by an attending neuroradiologist (RLR) who was blinded to all clinical data.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Methods > Fetal Brain MRI
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The temporal relationship between fetal MRI and echocardiograms differed between control and CHD groups; therefore, comparison of cardiovascular parameters was not possible between these groups.”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Discussion > Limitations
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“1H-MRS spectra were successfully obtained in 75 fetuses, 36 with CHD (72%) and 39 controls (71%).”
§ Brain Volume and Metabolism in Fetuses with Congenital Heart Disease: Evaluation with Quantitative Magnetic Resonance Imaging and Spectroscopy > Results > Fetal Brain MRI
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
The authors state this as an assumption.
Circulatory abnormalities in fetuses with complex congenital heart disease such as hypoplastic left heart syndrome, transposition of the great arteries and pulmonary atresia place them at risk of inadequate delivery of oxygen and metabolic substrate to the developing brain, slowing brain growth and impairing cortical organization and myelination.
“The basis for this hypothesis was the assumption that circulatory abnormalities in fetuses with these anomalies would place them at risk for inadequate delivery of oxygen and metabolic substrate to the developing brain, slowing normal brain growth and impairing cortical organization and myelination.”
The paper relies on this without support.
The content of oxygen and glucose in cerebral arterial blood is abnormal in fetuses with some forms of complex congenital heart disease.
“Thus, in theory, the content of oxygen and glucose in cerebral arterial blood is likely to be abnormal in fetuses with some forms of complex CHD, although there are no data of which we are aware to support this speculation.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In fetuses and neonates with critical CHD, chronically decreased oxygen and nutrient delivery disturbs optimal cerebral development, resulting in slower brain growth with delayed maturation when compared with healthy controls.9,10”
From Perioperative neonatal brain injury is associated with worse school-age neurodevelopment in children with critical congenital heart disease (2018) · cites this paper as [9]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Metabolic alterations in the in utero fetal brain have been shown to precede morphologic brain changes [104]”
From Brain structural and functional outcomes in the offspring of women experiencing psychological distress during pregnancy (2024) · cites this paper as [104]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Studies have reported that the PDMS detects deficits in motor functioning in 42% of young children with repaired CHD; however, the utility of early administration of the PDMS during infancy has not been reported [24].”
From Early Evaluation and the Effect of Socioeconomic Factors on Neurodevelopment in Infants with Tetralogy of Fallot. (2021) · cites this paper as [24]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Studies have reported that the PDMS detects deficits in motor functioning in 42% of young children with repaired CHD; however, the utility of early administration of the PDMS during infancy has not been reported [24].”
From Early Evaluation and the Effect of Socioeconomic Factors on Neurodevelopment in Infants with Tetralogy of Fallot. (2021) · cites this paper as [24]
Experimental — accuracy not yet measuredIn the citing paper
“In the fetal phase, reduced flow through the systemic ventricle (measured with echocardiography) is associated with smaller total volume of the brain.37”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [37]
In the citing paper
“This is most pronounced in HLHS and TGA: lower brain volume was associated with lower combined ventricular cardiac output, or absence of antegrade flow through the aortic valve.”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [37]
In the citing paper
“With increasing gestational age, greater deviation of total brain volume in CHD is seen during the antenatal period.[35][36][37]”
From Neuroimaging, cardiovascular physiology, and functional outcomes in infants with congenital heart disease (2017) · cites this paper as [37]
In the citing paper
“The successful applications of advanced magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS) techniques to the living fetus30,31,32 provide an unprecedented opportunity to study the association between maternal psychological distress and human fetal brain development.”
From Association of prenatal maternal psychological distress with fetal brain growth, metabolism, and cortical maturation. (2020) · cites this paper as [30]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
CHD and control group sizes are reversed in the abstract
MajorThe abstract reports 55 fetuses with CHD and 50 controls, whereas the Results section reports 50 with CHD and 55 controls. The spectroscopy counts and percentages also align with the Results section's group sizes.
“Brain volume and metabolism were compared prospectively between 55 fetuses with CHD and 50 normal fetuses using 3-D volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (1H-MRS).”
“In the remaining 105 fetuses (50 CHD, 55 controls), MRI was performed at a median GA of 30 weeks (25 1/7 -37 1/7 weeks).”
Citations
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Brain maturation is delayed in infants with complex congenital heart defects
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The Congenital Heart Disease Brain: Prenatal Considerations for Perioperative Neurocritical Care
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Abeysekera, J., Gyenes, D. L., Atallah, J., Robertson, C. M. T., Bond, G. Y., Rebeyka, I. M., Moez, E. K., Dinu, I. A., Switzer, H. N., & Hornberger, L. K. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2020.06.024 · Cited by 17
Mapping the developing human brain in utero using quantitative MR imaging techniques
Studholme, C. (2015) · Seminars in Perinatology · doi:10.1053/j.semperi.2015.01.003 · Cited by 17
Everwijn, S. M. P., Namburete, A. I. L., van Geloven, N., Jansen, F. A. R., Papageorghiou, A. T., Noble, J. A., Teunissen, A. K. K., Rozendaal, L., Blom, N. A., Lith, J. M. M. V., et al. (2019) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.13687 · Cited by 16
Morton, S. U., Maleyeff, L., Wypij, D., Yun, H. J., Rollins, C. K., Watson, C. G., Newburger, J. W., Bellinger, D. C., Roberts, A. E., Rivkin, M. J., et al. (2021) · Cerebral Cortex · doi:10.1093/cercor/bhab114 · Cited by 16
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Xie, L., Li, J., Yang, Z., Shi, K., Xu, H., Li, R., Diao, K., & Guo, Y. (2017) · PLoS ONE · doi:10.1371/journal.pone.0187578 · Cited by 15
Ehrler, M., Naef, N., Tuura, R., & Latal, B. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-032363 · Cited by 15
Andescavage, N. N., & Limperopoulos, C. (2021) · Experimental Neurology · doi:10.1016/j.expneurol.2021.113868 · Cited by 15
Self-citationWu, Y., Lu, Y.-C., Kapse, K. J., Jacobs, M. B., Andescavage, N. N., Donofrio, M. T., Lopez, C., Quistorff, J. L., Vézina, G., Krishnan, A. N., et al. (2021) · Cerebral Cortex · doi:10.1093/cercor/bhab386 · Cited by 15
Self-citationSchlatterer, S. D., Govindan, R. B., Murnick, J. G., Barnett, S. D., Lopez, C., Donofrio, M. T., Mulkey, S. B., Limperopoulos, C., & du Plessis, A. J. (2021) · Pediatric Research · doi:10.1038/s41390-021-01931-7 · Cited by 15
Self-citationDiNardo, J. A. (2010) · Pediatric Anesthesia · doi:10.1111/j.1460-9592.2010.03429.x · Cited by 15
Infection and white matter injury in infants with congenital cardiac disease
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Andescavage, N. N., Bullen, T., Liggett, M., Barnett, S. D., Kapse, A., Kapse, K. J., Ahmadzia, H. K., Vézina, G., Quistorff, J. L., Lopez, C., et al. (2022) · Pediatric Research · doi:10.1038/s41390-022-02340-0 · Cited by 14
Self-citationNeuro-developmental outcome in single-ventricle patients: is the Norwood procedure a risk factor?
Rotermann, I., Logoteta, J., Falta, J., Wegner, P., Jung, O., Dütschke, P., Scheewe, J., Kramer, H., & Hansen, J. H. (2017) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezx119 · Cited by 14
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Self-citationPlacental and Fetal In Utero Growth Among Fetuses With Congenital Heart Disease
Jacobwitz, M., Kapse, K. J., Ngwa, J. S., Asis‐Cruz, J. D., Wu, Y., Donofrio, M. T., McDermott, C., du Plessis, A., Limperopoulos, C., & Andescavage, N. N. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.7217 · Cited by 13
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2010 Report from the ISPD Special Interest Group fetal therapy: fetal cardiac interventions
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Improving maternal–infant bonding after prenatal diagnosis of CHD
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New Aspects in the Diagnosis and Therapy of Fetal Hypoplastic Left Heart Syndrome
Graupner, O., Enzensberger, C., & Axt-Fliedner, R. (2019) · Geburtshilfe und Frauenheilkunde · doi:10.1055/a-0828-7968 · Cited by 12
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Longitudinal Trends in Pediatric Survival by Congenital Heart Defect in Texas, 1999 to 2017
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The Role of Proton Magnetic Resonance Spectroscopy in Neonatal and Fetal Brain Research
Hui, S. C. N., Andescavage, N. N., & Limperopoulos, C. (2025) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.29709 · Cited by 11
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Self-citationNeurodevelopmental Delay After the Neonatal Repair of Coarctation and Arch Obstruction
Simon, B. V., Swartz, M. F., Orie, J. M., Adams, H., Seltzer, L. E., Angona, R. E., Atallah-Yunes, N. H., & Alfieris, G. M. (2019) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2019.04.088 · Cited by 11
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Metadata
- Authors
- Limperopoulos, C., Tworetzky, W., McElhinney, D. B., Newburger, J. W., Brown, D. W., Robertson, R. L., Guizard, N., McGrath, E., Geva, J., Annese, D., Dunbar-Masterson, C., Trainor, B., Laussen, P. C., & du Plessis, A. J.
- Affiliations
- McGill University (CA)
- From the Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada (C.L., N.G.); and Fetal-Neonatal Neurology Research Group, Department of Neurology (C.L., A.J.d.P.), and Departments of Cardiology and Pediatrics (W.T., D.B.M., J.W.N., D.W.B., E.M., J.G., D.A., C.D.-M., B.T.), Radiology (R.L.R.), and Cardiology and Anaesthesia (P.C.L.), Children’s Hospital Boston and Harvard Medical School, Boston, Mass.
- ORCID
- Venue
- Circulation
- Published
- 2010-01-05
- Volume
- 121
- Issue
- 1
- Pages
- 26-33
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC2819908
- OpenAlex
- W2068174282
- Cited by
- 663
- References
- 41
- Citations by year
- 2026: 37 · 2025: 50 · 2024: 38 · 2023: 37 · 2022: 49 · 2021: 55 · 2020: 48 · 2019: 49 · 2018: 43 · 2017: 42 · 2016: 49 · 2015: 35 · 2014: 26 · 2013: 31 · 2012: 22
- FWCI
- 16.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Heart Association
- Canadian Institutes of Health Research (81116_1)
- National Institute of Neurological Disorders and Stroke (K24NS057568)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Keywords
- congenital heart disease, fetal brain volume, fetal brain metabolism, cerebral lactate, cerebrospinal fluid volume, neurodevelopmental outcomes, fetal hemodynamics, third trimester
- MeSH terms
- Aspartic Acid, Brain, Choline, Female, Gestational Age, Heart Defects, Congenital, Humans, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Pregnancy, Prenatal Diagnosis, Prospective Studies, Protons, Lactic Acid, Imaging, Three-Dimensional
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
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