Objective: The objective of the study is to investigate the prenatal influence of congenital heart defects (CHD) on trajectories of fetal cortical folding using three-dimensional ultrasound (3D US). Method: We included 20 CHD fetuses and 193 controls for studying the fetal brain at 22, 26 and 32 weeks' gestational age (GA). The Sylvian, insula and parieto-occipital fissure (POF) depths were measured using 3D US, and reliability was evaluated. Doppler indices of the umbilical artery and middle cerebral artery were measured to calculate the cerebro-placental ratio. Associations between CHD and cortical folding were estimated using linear mixed models. Results: Brain fissure measurements were successful in over 80% of 3D US scans, except for the POF at 32 weeks' GA (65%). All measurements showed a good reliability (intraclass correlation coefficients > 0.84). Growth trajectories of the left insula depth (ß = −2.753, 95% CI = −5.375; −0.130, p = 0.040) and right POF (ß = −3.762, 95% CI = −7.178; −0.346, p = 0.031) were decreased in CHD compared with controls, whereas growth rates were increased (ß = 0.014, 95% CI = 0.001; 0.027, p = 0.036 and ß = 0.024, 95% CI = 0.007; 0.041, p = 0.006). In contrast to controls, we found no associations between cerebro-placental ratio and cortical folding in CHD. Conclusion: Fetal cortical folding can be evaluated reliably by measuring brain fissure depths. Trajectories of cortical folding between 22 and 32 weeks' GA seem to be influenced by CHD.

Additional Metadata
Persistent URL dx.doi.org/10.1002/pd.5135, hdl.handle.net/1765/102777
Journal Prenatal Diagnosis
Koning, I.V, van Graafeiland, A.W. (Anne W.), Groenenberg, I.A.L, Husen, S.C, Go, A.T.J.I, Dudink, J, … Steegers-Theunissen, R.P.M. (2017). Prenatal influence of congenital heart defects on trajectories of cortical folding of the fetal brain using three-dimensional ultrasound. Prenatal Diagnosis, 37(10), 1008–1016. doi:10.1002/pd.5135