scholarly journals Neuroplacentology in congenital heart disease: placental connections to neurodevelopmental outcomes

Author(s):  
Rachel L. Leon ◽  
Imran N. Mir ◽  
Christina L. Herrera ◽  
Kavita Sharma ◽  
Catherine Y. Spong ◽  
...  

Abstract Children with congenital heart disease (CHD) are living longer due to effective medical and surgical management. However, the majority have neurodevelopmental delays or disorders. The role of the placenta in fetal brain development is unclear and is the focus of an emerging field known as neuroplacentology. In this review, we summarize neurodevelopmental outcomes in CHD and their brain imaging correlates both in utero and postnatally. We review differences in the structure and function of the placenta in pregnancies complicated by fetal CHD and introduce the concept of a placental inefficiency phenotype that occurs in severe forms of fetal CHD, characterized by a myriad of pathologies. We propose that in CHD placental dysfunction contributes to decreased fetal cerebral oxygen delivery resulting in poor brain growth, brain abnormalities, and impaired neurodevelopment. We conclude the review with key areas for future research in neuroplacentology in the fetal CHD population, including (1) differences in structure and function of the CHD placenta, (2) modifiable and nonmodifiable factors that impact the hemodynamic balance between placental and cerebral circulations, (3) interventions to improve placental function and protect brain development in utero, and (4) the role of genetic and epigenetic influences on the placenta–heart–brain connection. Impact Neuroplacentology seeks to understand placental connections to fetal brain development. In fetuses with CHD, brain growth abnormalities begin in utero. Placental microstructure as well as perfusion and function are abnormal in fetal CHD.

1996 ◽  
Vol 19 (2-3) ◽  
pp. 141-149 ◽  
Author(s):  
John H. Gilmore ◽  
Diana O. Perkins ◽  
Mark A. Kliewer ◽  
Marvin L. Hage ◽  
Susan G. Silva ◽  
...  

NeuroImage ◽  
2006 ◽  
Vol 33 (2) ◽  
pp. 463-470 ◽  
Author(s):  
Rachel Grossman ◽  
Chen Hoffman ◽  
Yael Mardor ◽  
Anat Biegon

2019 ◽  
Vol 10 (7) ◽  
pp. 3307-3317 ◽  
Author(s):  
Juan C. Velasquez ◽  
Qiuying Zhao ◽  
Yen Chan ◽  
Ligia C.M. Galindo ◽  
Christelle Simasotchi ◽  
...  

2014 ◽  
Vol 16 (3) ◽  
pp. 307-320 ◽  

Obesity is now epidemic worldwide. Beyond associated diseases such as diabetes, obesity is linked to neuropsychiatric disorders such as depression. Alarmingly maternal obesity and high-fat diet consumption during gestation/lactation may "program" offspring longterm for increased obesity themselves, along with increased vulnerability to mood disorders. We review the evidence that programming of brain and behavior by perinatal diet is propagated by inflammatory mechanisms, as obesity and high-fat diets are independently associated with exaggerated systemic levels of inflammatory mediators. Due to the recognized dual role of these immune molecules (eg, interleukin [IL]-6, 11-1β) in placental function and brain development, any disruption of their delicate balance with growth factors or neurotransmitters (eg, serotonin) by inflammation early in life can permanently alter the trajectory of fetal brain development. Finally, epigenetic regulation of inflammatory pathways is a likely candidate for persistent changes in metabolic and brain function as a consequence of the perinatal environment.


2008 ◽  
Vol 32 (6) ◽  
pp. 380-386 ◽  
Author(s):  
Gabriella Morreale de Escobar ◽  
Susana Ares ◽  
Pere Berbel ◽  
María Jesus Obregón ◽  
Francisco Escobar del Rey

Author(s):  
Roopali Soni ◽  
Charlotte Tscherning Wel-Wel ◽  
Nicola J Robertson

Advances in neonatal–perinatal medicine have resulted in increased survival at lower gestations. Although the incidence of germinal matrix haemorrhage-intraventricular haemorrhage and cystic periventricular leucomalacia is reducing, a new phenotype of preterm brain injury has emerged consisting of a combination of destructive and dysmaturational effects. Consequently, severe neurological disability is reported at a lower rate than previously, but the overall morbidity associated with premature birth continues to present a large global burden and contributes significantly to increased financial costs to health systems and families. In this review, we examine the developmental milestones of fetal brain development and how preterm birth can disrupt this trajectory. We review common morbidities associated with premature birth today. Although drug-based and cell-based neuroprotective therapies for the preterm brain are under intense study, we outline basic, sustainable and effective non-medical, family-centred and developmental care strategies which have the potential to improve neurodevelopmental outcomes for this population and need to be considered part of the future neuroprotection care bundle.


Author(s):  
Panagiotis Antsaklis ◽  
Sebija Izetbegovic

ABSTRACT Defining normal and abnormal fetal neurological function in utero in order to better predict antenatally which fetuses are at risk for adverse neurological outcome has remained a great challenge in perinatal medicine. Fetal behavioral patterns have been considered as indicators of fetal brain development. It has been suggested that the assessment of fetal behavior in different periods of gestation may make possible the distinction between normal and abnormal brain development. Advances in ultrasound technology and particularly the introduction of real time four-dimensional (4D) ultrasonography, allowed direct observation of in utero life and offered a new insight for the assessment of fetal behavior. Fetal behavioral movements, the full range of facial expressions and mobility of fetal upper and lower extremities and fingers can be clearly visualized with 4D ultrasound. A new scoring system for the assessment of fetal neurobehavior based on prenatal assessment of the fetus with 4D sonography has been developed based on the same technique that neonatologists assess newborns during the first days of their postnatal life. This overview focuses on the study of fetal behavior and neurological assessment with 4D ultrasound. How to cite this article Antsaklis P, Kurjak A, Izetbegovic S. Functional Test for Fetal Brain: The Role of KANET Test. Donald School J Ultrasound Obstet Gynecol 2013;7(4):385-399.


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