Abstract

Children with congenital heart defects (CHDs) have increased risk of cognitive disabilities for reasons not fully understood. Previous studies have indicated signs of disrupted fetal brain growth from mid-gestation measured with ultrasound and magnetic resonance imaging (MRI) and infants with CHDs have decreased brain volumes at birth. We measured the total and regional brain volumes of infants with and without CHDs using MRI to investigate, if certain areas of the brain are at particular risk of disrupted growth. MRI brain volumetry analyses were performed on 20 infants; 10 with- (postmenstrual age 39–54 weeks, mean 44 weeks + 5 days) and 10 without CHDs (postmenstrual age 39–52 weeks, mean 43 weeks + 5 days). In six infants with- and eight infants without CHDs grey and white matter were also differentiated. Infants with CHDs had smaller brains (48 ml smaller; 95% CI, 6.1–90; p = 0.03), cerebrums (37.8 ml smaller; 95% CI, 0.8–74.8; p = 0.04), and cerebral grey matter (25.8 ml smaller; 95% CI, 3.5–48; p = 0.03) than infants without CHD. Brain volume differences observed within weeks after birth in children with CHDs confirm that the brain impact, which increase the risk of cognitive disabilities, may begin during pregnancy.

Highlights

  • Children with congenital heart defects (CHDs) have increased risk of cognitive disabilities for reasons not fully understood

  • In children with CHDs, smaller regional brain volumes have been associated with cognitive i­mpairments[10,13]

  • The gender composition and postmenstrual ages at the time of the magnetic resonance imaging (MRI) scan were similar across infants with and without CHDs (Table 1)

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Summary

Introduction

Children with congenital heart defects (CHDs) have increased risk of cognitive disabilities for reasons not fully understood. We measured the total and regional brain volumes of infants with and without CHDs using MRI to investigate, if certain areas of the brain are at particular risk of disrupted growth. In children with CHDs, smaller regional brain volumes have been associated with cognitive i­mpairments[10,13]. CHDs have been associated with hemorrhagic and ischemic brain lesions, predominately in the white matter (WM)[5,6,26,27,28,29,30] and magnetic resonance imaging (MRI) studies of infants with CHDs have shown both pre- and postoperative brain volume a­ bnormalities[9,12,16,18,25,27,28]. More detailed information on regional brain volume variations may enable the early identification of specific domains of later impairments and possibly allow for earlier intervention

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