Prenatal head growth and white matter injury in hypoplastic left heart syndrome. Pediatr Res 2008 Oct;64(4):364-9
Date
06/17/2008Pubmed ID
18552707Pubmed Central ID
PMC2681225DOI
10.1203/PDR.0b013e3181827bf4Scopus ID
2-s2.0-55049091297 (requires institutional sign-in at Scopus site) 111 CitationsAbstract
Children with hypoplastic left heart syndrome (HLHS) have an increased prevalence of central nervous system (CNS) abnormalities. The extent to which this problem is due to CNS maldevelopment, prenatal ischemia, postnatal chronic cyanosis and/or multiple exposures to cardiopulmonary bypass is unknown. To better understand the etiology of CNS abnormalities in HLHS, we evaluated 68 neonates with HLHS; in 28 cases, both fetal ultrasound and echocardiogram data were available to assess head size, head growth and aortic valve anatomy (atresia or stenosis). In addition, we evaluated neuropathology in 11 electively aborted HLHS fetuses. The mean head circumference percentile in HLHS neonates was significantly smaller than HLHS fetuses (22 +/- 2% versus 40 +/- 4%, p < 0.001). A significant decrease in head growth, defined as a 50% reduction in head circumference percentile, was observed in half (14/28) of HLHS fetuses and nearly a quarter (6/28) were already growth restricted (<or=10%) at the time of initial evaluation. Brains from HLHS fetuses demonstrated chronic diffuse white matter injury of varying severity. These patterns of prenatal head growth and brain histopathology identify a spectrum of abnormal CNS development and/or injury in HLHS fetuses.
Author List
Hinton RB, Andelfinger G, Sekar P, Hinton AC, Gendron RL, Michelfelder EC, Robitaille Y, Benson DWMESH terms used to index this publication - Major topics in bold
Aortic ValveCephalometry
Echocardiography
Head
Humans
Hypoplastic Left Heart Syndrome
Infant, Newborn
Ohio
