ObjectivesCongenital heart defects (CHD) are responsible for neurodevelopmental delays that were initially attributed to brain injury resulting from cardiac surgery. However, prenatal imaging have shown that brain anomalies are present at birth. The aim of this study was to assess in utero brain injuries before birth in fetuses/neonates with congenital cardiopathies.MethodsA complete autopsy evaluation with detailed study of the cardiopathy and neuropathological study was performed in 40 fetuses/neonates. Syndromic congenital cardiopathies were excluded because of the potential other causes of brain injury. The patients were classified into two groups according to their term at death.ResultsStatistical analyses indicated the mean brain weight was not significantly different between subjects with different morphological types of congenital cardiopathies. However, the brain weight was at or below the fifth percentile in most third-trimester subjects compared to normal brain weight in second-trimester subjects. Low brain weight in third-trimester subjects was also associated with frequent lesions similar to those described in preterm infants, with a particular involvement of white matter and its components.ConclusionsThese observations allowed us to establish the timing and impact of prenatal neuropathological lesions on brain development, and to correlate them with imaging data reported in the literature.

中文翻译：

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先天性心脏缺陷对大脑发育的影响

目的先天性心脏缺陷 (CHD) 是导致神经发育迟缓的原因，这些迟缓最初归因于心脏手术导致的脑损伤。然而，产前成像显示，大脑异常在出生时就存在。本研究的目的是在子宫内评估患有先天性心脏病的胎儿/新生儿出生前脑损伤。方法对 40 名胎儿/新生儿进行了完整的尸检评估，详细研究了心脏病和神经病理学研究。由于脑损伤的潜在其他原因，先天性心脏病综合征被排除在外。将患者根据死亡时间分为两组。结果统计分析表明，不同形态先天性心脏病患者的平均脑重无显着差异。然而，与孕中期受试者的正常脑重相比，大多数孕晚期受试者的脑重处于或低于第 5 个百分位。