Serial neurosonography in fetuses with congenital heart defects shows mild delays in cortical development

Sheila M. Everwijn; Jiska F. van Bohemen; Nan van Geloven; Fenna A. Jansen; Aalbertine K. Teunissen; Lieke Rozendaal; Nico Blom; Jan M. van Lith; Monique C. Haak

doi:10.1002/pd.6038

Serial neurosonography in fetuses with congenital heart defects shows mild delays in cortical development

Sheila M. Everwijn, Jiska F. van Bohemen, Nan van Geloven, Fenna A. Jansen, Aalbertine K. Teunissen, Lieke Rozendaal, Nico Blom, Jan M. van Lith, Monique C. Haak

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Neurodevelopmental delay is more common in children born with congenital heart defects (CHD), even with optimal perinatal and peri-operative care. It is hypothesized that fetuses with CHD are prone to neurological impairment in utero due to their cardiac defect, possibly leading to delayed cortical development. Methods: Cerebral cortical maturation was assessed with advanced neurosonographic examinations every 4 weeks in fetuses with CHD and compared to control fetuses. Five different primary fissures and four areas were scored (ranging 0–5) by blinded examiners using a cortical maturation scheme. Results: Cortical staging was assessed in 574 ultrasound examinations in 85 CHD fetuses and 61 controls. Small differences in grading were seen in Sylvian and cingulate fissures. (Sylvian fissure: −0.12 grade, 95% CI (−0.23; −0.01) p = 0.05, cingulate fissure: −0.24 grade, 95% CI (−0.38; −0.10) p = <0.001. Other cortical areas showed normal maturation as compared to control fetuses. Conclusion: Small differences were seen in three of the nine analyzed cortical areas in CHD fetuses, in contrast to previous reports on progressive third-trimester delay. The clinical implications of the small differences however, remain unknown.

Original language	English
Pages (from-to)	1649-1657
Number of pages	9
Journal	Prenatal Diagnosis
Volume	41
Issue number	13
DOIs	https://doi.org/10.1002/pd.6038
Publication status	Published - Dec 2021
Externally published	Yes

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@article{a87bf4d70aa04341ad37ee7da03dcbf2,

title = "Serial neurosonography in fetuses with congenital heart defects shows mild delays in cortical development",

abstract = "Introduction: Neurodevelopmental delay is more common in children born with congenital heart defects (CHD), even with optimal perinatal and peri-operative care. It is hypothesized that fetuses with CHD are prone to neurological impairment in utero due to their cardiac defect, possibly leading to delayed cortical development. Methods: Cerebral cortical maturation was assessed with advanced neurosonographic examinations every 4 weeks in fetuses with CHD and compared to control fetuses. Five different primary fissures and four areas were scored (ranging 0–5) by blinded examiners using a cortical maturation scheme. Results: Cortical staging was assessed in 574 ultrasound examinations in 85 CHD fetuses and 61 controls. Small differences in grading were seen in Sylvian and cingulate fissures. (Sylvian fissure: −0.12 grade, 95% CI (−0.23; −0.01) p = 0.05, cingulate fissure: −0.24 grade, 95% CI (−0.38; −0.10) p = <0.001. Other cortical areas showed normal maturation as compared to control fetuses. Conclusion: Small differences were seen in three of the nine analyzed cortical areas in CHD fetuses, in contrast to previous reports on progressive third-trimester delay. The clinical implications of the small differences however, remain unknown.",

author = "Everwijn, {Sheila M.} and {van Bohemen}, {Jiska F.} and {van Geloven}, Nan and Jansen, {Fenna A.} and Teunissen, {Aalbertine K.} and Lieke Rozendaal and Nico Blom and {van Lith}, {Jan M.} and Haak, {Monique C.}",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.",

year = "2021",

month = dec,

doi = "10.1002/pd.6038",

language = "English",

volume = "41",

pages = "1649--1657",

journal = "Prenatal Diagnosis",

issn = "0197-3851",

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TY - JOUR

T1 - Serial neurosonography in fetuses with congenital heart defects shows mild delays in cortical development

AU - Everwijn, Sheila M.

AU - van Bohemen, Jiska F.

AU - van Geloven, Nan

AU - Jansen, Fenna A.

AU - Teunissen, Aalbertine K.

AU - Rozendaal, Lieke

AU - Blom, Nico

AU - van Lith, Jan M.

AU - Haak, Monique C.

PY - 2021/12

Y1 - 2021/12

N2 - Introduction: Neurodevelopmental delay is more common in children born with congenital heart defects (CHD), even with optimal perinatal and peri-operative care. It is hypothesized that fetuses with CHD are prone to neurological impairment in utero due to their cardiac defect, possibly leading to delayed cortical development. Methods: Cerebral cortical maturation was assessed with advanced neurosonographic examinations every 4 weeks in fetuses with CHD and compared to control fetuses. Five different primary fissures and four areas were scored (ranging 0–5) by blinded examiners using a cortical maturation scheme. Results: Cortical staging was assessed in 574 ultrasound examinations in 85 CHD fetuses and 61 controls. Small differences in grading were seen in Sylvian and cingulate fissures. (Sylvian fissure: −0.12 grade, 95% CI (−0.23; −0.01) p = 0.05, cingulate fissure: −0.24 grade, 95% CI (−0.38; −0.10) p = <0.001. Other cortical areas showed normal maturation as compared to control fetuses. Conclusion: Small differences were seen in three of the nine analyzed cortical areas in CHD fetuses, in contrast to previous reports on progressive third-trimester delay. The clinical implications of the small differences however, remain unknown.

AB - Introduction: Neurodevelopmental delay is more common in children born with congenital heart defects (CHD), even with optimal perinatal and peri-operative care. It is hypothesized that fetuses with CHD are prone to neurological impairment in utero due to their cardiac defect, possibly leading to delayed cortical development. Methods: Cerebral cortical maturation was assessed with advanced neurosonographic examinations every 4 weeks in fetuses with CHD and compared to control fetuses. Five different primary fissures and four areas were scored (ranging 0–5) by blinded examiners using a cortical maturation scheme. Results: Cortical staging was assessed in 574 ultrasound examinations in 85 CHD fetuses and 61 controls. Small differences in grading were seen in Sylvian and cingulate fissures. (Sylvian fissure: −0.12 grade, 95% CI (−0.23; −0.01) p = 0.05, cingulate fissure: −0.24 grade, 95% CI (−0.38; −0.10) p = <0.001. Other cortical areas showed normal maturation as compared to control fetuses. Conclusion: Small differences were seen in three of the nine analyzed cortical areas in CHD fetuses, in contrast to previous reports on progressive third-trimester delay. The clinical implications of the small differences however, remain unknown.

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Serial neurosonography in fetuses with congenital heart defects shows mild delays in cortical development

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