Journal article
Reduced Fetal Cerebral Oxygen Consumption Is Associated With Smaller Brain Size in Fetuses With Congenital Heart Disease
Circulation (New York, N.Y.), Vol.131(15), pp.1313-1323
04/14/2015
DOI: 10.1161/CIRCULATIONAHA.114.013051
PMCID: PMC4398654
PMID: 25762062
Abstract
Background-Fetal hypoxia has been implicated in the abnormal brain development seen in newborns with congenital heart disease (CHD). New magnetic resonance imaging technology now offers the potential to investigate the relationship between fetal hemodynamics and brain dysmaturation.
Methods and Results-We measured fetal brain size, oxygen saturation, and blood flow in the major vessels of the fetal circulation in 30 late-gestation fetuses with CHD and 30 normal controls using phase-contrast magnetic resonance imaging and T2 mapping. Fetal hemodynamic parameters were calculated from a combination of magnetic resonance imaging flow and oximetry data and fetal hemoglobin concentrations estimated from population averages. In fetuses with CHD, reductions in umbilical vein oxygen content (P<0.001) and failure of the normal streaming of oxygenated blood from the placenta to the ascending aorta were associated with a mean reduction in ascending aortic saturation of 10% (P<0.001), whereas cerebral blood flow and cerebral oxygen extraction were no different from those in controls. This accounted for the mean 15% reduction in cerebral oxygen delivery (P=0.08) and 32% reduction cerebral Vo(2) in CHD fetuses (P<0.001), which were associated with a 13% reduction in fetal brain volume (P<0.001). Fetal brain size correlated with ascending aortic oxygen saturation and cerebral Vo(2) (r=0.37, P=0.004).
Conclusions-This study supports a direct link between reduced cerebral oxygenation and impaired brain growth in fetuses with CHD and raises the possibility that in utero brain development could be improved with maternal oxygen therapy.
Details
- Title: Subtitle
- Reduced Fetal Cerebral Oxygen Consumption Is Associated With Smaller Brain Size in Fetuses With Congenital Heart Disease
- Creators
- Liqun Sun - Shanghai Jiao Tong UniversityChristopher K. Macgowan - University of TorontoJohn G. Sled - University of TorontoShi-Joon Yoo - University of TorontoCedric Manlhiot - University of TorontoPrashob Porayette - University of TorontoLars Grosse-Wortmann - University of TorontoEdgar Jaeggi - University of TorontoBrian W. McCrindle - University of TorontoJohn Kingdom - University of TorontoEdward Hickey - University of TorontoSteven Miller - University of TorontoMike Seed - University of Toronto
- Resource Type
- Journal article
- Publication Details
- Circulation (New York, N.Y.), Vol.131(15), pp.1313-1323
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1161/CIRCULATIONAHA.114.013051
- PMID
- 25762062
- PMCID
- PMC4398654
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Number of pages
- 11
- Grant note
- U01HL068270 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Pediatric Heart Network (National Institutes of Health); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 04/14/2015
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics; Internal Medicine
- Record Identifier
- 9984353843902771
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