Functional brain maturation and sleep organisation in neonates with congenital heart disease

Hermans, Tim; Thewissen, Liesbeth; Gewillig, Marc; Cools, Björn; Jansen, Katrien; Pillay, Kirubin; Vos, Maarten De; S, Sabine Van Huffel; Naulaers, Gunnar; Dereymaeker, A

doi:10.1016/j.ejpn.2021.12.008

Cited by 4 publications

(2 citation statements)

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“…Impaired cerebral oxygenation due to intracardiac mixing is implicated as a major contributor of deficient neurodevelopment in fetuses with CHD [45][46][47][48]. In the fetal brain, decrease in temporal variance in the CHD group is indicative of delays in the emerging functional connectivity [49,50] and is consistent with a recent study that reported delay brain function in neonates with CHD [51]. Multiple in utero factors are likely to influence fetal brain dysmaturation and long term sequalae of neurodevelopmental impairment in CHD, including deleterious gene variants, environmental factors, fetal circulatory disturbances (reduced substrate delivery including oxygen, glucose and other nutrients).…”

Section: Discussionsupporting

confidence: 86%

Associations Between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

Rajagopalan

Schmithorst

El-Ali

et al. 2022

Preprint

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Background: The relationship between maternal risk factors (MRFs) (particularly pre-gravid obesity, diabetes, and hypertension) and congenital heart disease (CHD) to placental and fetal brain outcomes is poorly understood. Here, we tested the hypothesis that MRF and CHD would be associated with reduced intrinsic placental and fetal brain function using a novel non-invasive technique. Methods: Pregnant participants with and without MRF and fetal CHD were prospectively recruited and underwent feto-placental MRI. Using intrinsic properties of blood oxygen level dependent imaging (BOLD) we quantified spatiotemporal variance of placenta and fetal brain. MRFs and CHD were correlated with functional characteristics of the placenta and fetal brain. Results: Co- morbid MRF (hypertension, diabetes, and obesity) reduced spatiotemporal functional variance of placenta and fetal brain (p < 0.05). CHD predicted reduced fetal brain temporal variance compared to controls (p<0.05). Interaction of MRF and CHD status was associated with reduced intrinsic pBOLD temporal variance (p=0.047). There were no significant interactions of MRFs and CHD status on either temporal or spatial variance of intrinsic brain BOLD. Conclusion: MRF and CHD reduced functional characteristic of placenta and brain in fetuses. MRF modification and management during pregnancy may have the potential to not only provide additional risk stratification but may also improve neurodevelopmental outcomes.

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Section: Discussionsupporting

confidence: 86%

Associations Between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

Rajagopalan

Schmithorst

El-Ali

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Impaired cerebral oxygenation due to intracardiac mixing is implicated as a major contributor of deficient neurodevelopment in fetuses with CHD [ 49 , 50 , 51 , 52 ]. In the fetal brain, decrease in temporal variance in the CHD group is indicative of delays in the emerging functional connectivity [ 53 , 54 ] and is consistent with a recent study that reported delay brain function in neonates with CHD [ 55 ]. Multiple in utero factors are likely to influence fetal brain dysmaturation and long term sequalae of neurodevelopmental impairment in CHD, including deleterious gene variants, environmental factors, fetal circulatory disturbances (reduced substrate delivery including oxygen, glucose and other nutrients).…”

Section: Discussionsupporting

confidence: 84%

Associations between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

Rajagopalan

Schmithorst

El-Ali

et al. 2022

IJMS

View full text Add to dashboard Cite

The relationship between maternal risk factors (MRFs) (particularly pre-gravid obesity, diabetes, and hypertension) and congenital heart disease (CHD) to placental and fetal brain outcomes is poorly understood. Here, we tested the hypothesis that MRF and CHD would be associated with reduced intrinsic placental and fetal brain function using a novel non-invasive technique. Pregnant participants with and without MRF and fetal CHD were prospectively recruited and underwent feto-placental MRI. Using intrinsic properties of blood oxygen level dependent imaging (BOLD) we quantified spatiotemporal variance of placenta and fetal brain. MRFs and CHD were correlated with functional characteristics of the placenta and fetal brain. Co-morbid MRF (hypertension, diabetes, and obesity) reduced spatiotemporal functional variance of placenta and fetal brain (p < 0.05). CHD predicted reduced fetal brain temporal variance compared to non-CHD (p < 0.05). The presence of both MRF and CHD was associated with reduced intrinsic pBOLD temporal variance (p = 0.047). There were no significant interactions of MRFs and CHD status on either temporal or spatial variance of intrinsic brain BOLD. MRF and CHD reduced functional characteristic of placenta and brain in fetuses. MRF modification and management during pregnancy may have the potential to not only provide additional risk stratification but may also improve neurodevelopmental outcomes.

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Neonatal Seizures: New Evidence, Classification, and Guidelines

Ziobro,

Pilon,

Wusthoff

et al. 2024

Epilepsy Curr

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Neonates are susceptible to seizures due to their unique physiology and combination of risks associated with gestation, delivery, and the immediate postnatal period. Advances in neonatal care have improved outcomes for some of our most fragile patients, but there are persistent challenges for epileptologists in identifying neonatal seizures, diagnosing etiologies, and providing the most appropriate care, with an ultimate goal to maximize patient outcomes. In just the last few years, there have been critical advances in the state of the science, as well as new evidence-based guidelines for diagnosis, classification, and treatment of neonatal seizures. This review will provide updated knowledge about the pathophysiology of neonatal seizures, classification of the provoked seizures and neonatal epilepsies, state of the art guidance on EEG monitoring in the neonatal ICU, current treatment guidelines for neonatal seizures, and potential for future advancement in treatment.

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Functional brain maturation and sleep organisation in neonates with congenital heart disease

Cited by 4 publications

References 69 publications

Associations Between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

Associations Between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

Associations between Maternal Risk Factors and Intrinsic Placental and Fetal Brain Functional Properties in Congenital Heart Disease

Neonatal Seizures: New Evidence, Classification, and Guidelines

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