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The association between flow and oxygenation and cortical development in fetuses with congenital heart defects using a brain-age prediction algorithm.

Everwijn, SMP; Namburete, AIL; van Geloven, N; Jansen, FAR; Papageorghiou, AT; Teunissen, AK; Rozendaal, L; Blom, N; van Lith, JM; Haak, MC (2021) The association between flow and oxygenation and cortical development in fetuses with congenital heart defects using a brain-age prediction algorithm. Prenat Diagn, 41 (1). pp. 43-51. ISSN 1097-0223 https://doi.org/10.1002/pd.5813
SGUL Authors: Papageorghiou, Aris

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Abstract

OBJECTIVES: Presumably, changes in fetal circulation contribute to the delay in maturation of the cortex in fetuses with congenital heart defect (CHD). The aim of the current study is to analyze fetal brain development based on hemodynamic differences, using novel brain-age prediction software. METHODS: We have performed detailed neurosonography, including acquiring 3D volumes, prospectively in cases with isolated CHD from 20 weeks onwards. An algorithm that assesses the degree of fetal brain-age automatically was used to compare CHD cases to controls. We stratified CHD cases according to flow and oxygenation profiles by lesion physiology and performed subgroup analyses. RESULTS: A total of 616 ultrasound volumes of 162 CHD cases and 75 controls were analyzed. Significant differences in maturation of the cortex were observed in cases with normal blood flow toward the brain (-3.8 days, 95%CI [-5.5; -2.0], P = <.001) and low (-4.0 days, 95% CI [-6.7; -1.2] P = <.05; hypoplastic left heart syndrome[HLHS]) and mixed (-4.4 days, 95%CI [-6.4; -2.5] p = <.001) oxygen saturation in the ascending aorta (TGA) and in cardiac mixing (eg, Fallot) cases. CONCLUSION: The current study shows significant delay in brain-age in TGA and Fallot cases as compared to control cases. However, the small differences found in this study questions the clinical relevance.

Item Type: Article
Additional Information: © 2020 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Keywords: Adult, Algorithms, Case-Control Studies, Cerebral Cortex, Cerebrovascular Circulation, Female, Heart Defects, Congenital, Humans, Neuroimaging, Pregnancy, Software, Ultrasonography, Prenatal, Cerebral Cortex, Humans, Heart Defects, Congenital, Ultrasonography, Prenatal, Case-Control Studies, Pregnancy, Cerebrovascular Circulation, Algorithms, Software, Adult, Female, Neuroimaging, 1103 Clinical Sciences, 1114 Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: Prenat Diagn
ISSN: 1097-0223
Language: eng
Dates:
DateEvent
26 January 2021Published
7 September 2020Published Online
7 August 2020Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
PubMed ID: 33448406
Web of Science ID: WOS:000566509200001
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/114773
Publisher's version: https://doi.org/10.1002/pd.5813

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