Prenatal head growth and white matter injury in hypoplastic left heart syndrome

Robert B. Hinton, Gregor Andelfinger, Priya Sekar, Andrea C. Hinton, Roxanne L. Gendron, Erik C. Michelfelder, Yves Robitaille, D. Woodrow Benson

Research output: Contribution to journalArticle

Abstract

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 (≤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.

Original languageEnglish (US)
Pages (from-to)364-369
Number of pages6
JournalPediatric Research
Volume64
Issue number4
DOIs
StatePublished - Oct 2008
Externally publishedYes

Fingerprint

Hypoplastic Left Heart Syndrome
Head
Wounds and Injuries
Growth
Fetus
Central Nervous System
Nervous System Malformations
Newborn Infant
Nervous System Trauma
White Matter
Cyanosis
Brain
Cardiopulmonary Bypass
Aortic Valve
Anatomy
Pathologic Constriction
Ischemia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Hinton, R. B., Andelfinger, G., Sekar, P., Hinton, A. C., Gendron, R. L., Michelfelder, E. C., ... Benson, D. W. (2008). Prenatal head growth and white matter injury in hypoplastic left heart syndrome. Pediatric Research, 64(4), 364-369. https://doi.org/10.1203/PDR.0b013e3181827bf4

Prenatal head growth and white matter injury in hypoplastic left heart syndrome. / Hinton, Robert B.; Andelfinger, Gregor; Sekar, Priya; Hinton, Andrea C.; Gendron, Roxanne L.; Michelfelder, Erik C.; Robitaille, Yves; Benson, D. Woodrow.

In: Pediatric Research, Vol. 64, No. 4, 10.2008, p. 364-369.

Research output: Contribution to journalArticle

Hinton, RB, Andelfinger, G, Sekar, P, Hinton, AC, Gendron, RL, Michelfelder, EC, Robitaille, Y & Benson, DW 2008, 'Prenatal head growth and white matter injury in hypoplastic left heart syndrome', Pediatric Research, vol. 64, no. 4, pp. 364-369. https://doi.org/10.1203/PDR.0b013e3181827bf4
Hinton RB, Andelfinger G, Sekar P, Hinton AC, Gendron RL, Michelfelder EC et al. Prenatal head growth and white matter injury in hypoplastic left heart syndrome. Pediatric Research. 2008 Oct;64(4):364-369. https://doi.org/10.1203/PDR.0b013e3181827bf4
Hinton, Robert B. ; Andelfinger, Gregor ; Sekar, Priya ; Hinton, Andrea C. ; Gendron, Roxanne L. ; Michelfelder, Erik C. ; Robitaille, Yves ; Benson, D. Woodrow. / Prenatal head growth and white matter injury in hypoplastic left heart syndrome. In: Pediatric Research. 2008 ; Vol. 64, No. 4. pp. 364-369.
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