Brain development in fetuses with Congenital Heart Disease
Yao Wu, PhD
BACKGROUND: Abnormal brain development has been observed in newborns with congenital heart disease (CHD) before cardiac surgery. Developmental disabilities in surviving infants with CHD following successful surgical repair continue to be on the rise. We provided the first in vivo evidence that brain growth and metabolism in the third-trimester fetus with complex CHD is impaired in the womb; however, the extent to which selective brain regions may be vulnerable in the CHD fetus has not been elucidated.
GAP: We propose to use advanced non-invasive fetal MRI tools to examine global and regional brain development in the human fetuses diagnosed with CHD compared to gestational age (GA) matched healthy fetuses.
HYPOTHESIS: 1) CHD fetuses will demonstrate progressive impairments in global and regional brain growth compared to healthy controls; 2) CHD newborns, prior to open heart surgery, that showed decreased prenatal brain growth will demonstrate more pronounced brain growth disturbances compared to healthy neonates; 3) Impaired fetal and neonatal brain growth will be associated with neurobehavioral problems in CHD infants.
METHODS: We will prospectively measure the brain development in 50 fetuses diagnosed with CHD and 50 healthy fetuses at three critical time points: 1) in the second trimester (24‐28 weeks GA), 2) third trimester of pregnancy (33‐37 weeks GA), 3) postnatally, before surgery. Fetal and neonatal MRI measures will be correlated with the neurobehavioral assessment in infants.
IMPACT: Identifying early brain dysfunction in CHD and understanding its impact on later neurodevelopment is critical for developing early and rational treatment strategies to better support this high-risk population and optimize fetal development.