Neurodevelopment in infants with CHD may be predicted in utero

DENVER — Selective impairments in regional fetal brain growth predicted adverse development among infants with congenital heart disease, according to study findings presented at the Pediatric Academic Societies Meeting.

The results suggest that neurodevelopment in infants with CHD may be predicted early in utero, which could assist with providing early targeted interventions in a child’s first years.

Yao Wu, PhD, co-author and a member of the research faculty at the Children’s National Hospital Developing Brain Institute, told Healio that fetuses with complex CHD are at high risk for impaired prenatal brain development, and children with complex CHD experience long-term developmental disabilities, but “the relationship between altered fetal brain growth and infant neurodevelopmental outcomes in CHD remains largely unknown.”

Wu and colleagues recruited mothers whose pregnancies were complicated by a fetal CHD diagnosis — a total of 186 mother-baby dyads. The subjects then underwent a fetal MRI, and the researchers quantified global and regional fetal brain volumes on three-dimensional reconstructions of the MRI. Finally, once the infants turned 18 months old, they were given the Bayley Scales of Infant and Toddler Development III, the Infant-Toddler Social and Emotional Assessment and the Modified Checklist for Autism in Toddlers to test their development.

Ultimately, the researchers found that infants with single-ventricle CHD showed greater susceptibility to social-emotional problems compared with infants with double-ventricle CHD, a result suggests prenatal brain growth impairments could be a biomarker for later neurodevelopment dysfunction. Wu said the findings were in line with his team’s previous findings.

“Our team already has published research that shows a direct association between elevated maternal stress and impaired fetal brain development,” Wu said. “Evidence-based interventions that relieve maternal stress, thus, would help the mother and might have the added benefit of safeguarding some of the baby’s brain function.”

Wu added that the work is not over.

“Our surgical colleagues have worked wonders in innovating solutions to heart anomalies, sometimes operating on tiny babies within hours of childbirth,” Wu said. “Our field needs to continue to innovate to identify and test interventions even earlier in pregnancy to help children born with this very common birth defect live longer and healthier lives.”

Reference:

Wu Y, et al. Impaired prenatal brain growth predicts adverse neurodevelopmental outcomes in infants with congenital heart disease. Presented at: Pediatric Academic Societies Meeting; April 21-25, 2022.