Cited by 118Congenital Heart Disease StudiesFetal and Pediatric Neurological DisordersNeonatal and fetal brain pathology

Prenatal Head Growth and White Matter Injury in Hypoplastic Left Heart Syndrome

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Hinton, Robert B, Andelfinger, Gregor, Sekar, Priya, Hinton, Andrea C, Gendron, Roxanne L, Michelfelder, Erik C, Robitaille, Yves, Benson, D Woodrow·2008·Pediatric Research

Abstract

Children with hypoplastic left heart syndrome (HLHS) have an increased prevalence of central nervous system (CNS) abnormalities. The extent to which this problem is due to CNS maldevelopment, prenatal ischemia, postnatal chronic cyanosis and/or multiple exposures to cardiopulmonary bypass is unknown. To better understand the etiology of CNS abnormalities in HLHS, we evaluated 68 neonates with HLHS; in 28 cases, both fetal ultrasound and echocardiogram data were available to assess head size, head growth and aortic valve anatomy (atresia or stenosis). In addition, we evaluated neuropathology in 11 electively aborted HLHS fetuses. The mean head circumference percentile in HLHS neonates was significantly smaller than HLHS fetuses (22 +/- 2% versus 40 +/- 4%, p < 0.001). A significant decrease in head growth, defined as a 50% reduction in head circumference percentile, was observed in half (14/28) of HLHS fetuses and nearly a quarter (6/28) were already growth restricted (<or=10%) at the time of initial evaluation. Brains from HLHS fetuses demonstrated chronic diffuse white matter injury of varying severity. These patterns of prenatal head growth and brain histopathology identify a spectrum of abnormal CNS development and/or injury in HLHS fetuses.

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Authors
Hinton, R. B., Andelfinger, G., Sekar, P., Hinton, A. C., Gendron, R. L., Michelfelder, E. C., Robitaille, Y., & Benson, D. W.
Affiliations
  • Cincinnati Children's Hospital Medical Center (US)
  • Good Samaritan Hospital (US)
  • Université de Montréal (CA)
Venue
Pediatric Research
Published
2008-10
Volume
64
Issue
4
Pages
364-369
ISSN
  • 0031-3998 (ISSN-L)
  • 1530-0447
OpenAlex
W2004723483
Cited by
118
References
47
Citations by year
2026: 3 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 2 · 2020: 7 · 2019: 11 · 2018: 8 · 2017: 14 · 2016: 10 · 2015: 8 · 2014: 5 · 2013: 9 · 2012: 9
FWCI
3.71
Type
journal article
Language
en
Open access
Locations
  • Pediatric Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • U.S. Public Health Service (GMHD79045)
  • Canadian Institutes of Health Research
  • National Heart, Lung, and Blood Institute (HL 085122, HL 069712, K23HL085122, K24HL069712)
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
hypoplastic left heart syndrome, white matter injury, fetal brain development, head circumference, fetal growth restriction, aortic valve anatomy, cardiopulmonary bypass, chronic cyanosis
MeSH terms
Aortic Valve, Cephalometry, Echocardiography, Head, Humans, Infant, Newborn, Ohio, Hypoplastic Left Heart Syndrome

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