New research explores brain growth in unborn babies with congenital heart disease

Researchers from King's College London and Evelina London have found that having congenital heart disease can affect the brain development of unborn babies. This is because some types of congenital heart disease affect the blood supply to the brain before birth.

Congenital heart disease is the general term for a group of conditions in which the heart does not develop normally in the womb. It is one of the most common types of birth defect.

Some children with congenital heart disease may also have abnormal brain development and difficulties with learning, but the reasons for this have not been clear.

To study this, researchers split different types of congenital heart disease into groups according to how they might affect the delivery of oxygen and nutrients into the brain (cerebral substrate delivery).

They then used advanced fetal MRI techniques to show that the unborn babies with congenital heart disease associated with lower cerebral substrate delivery tended to have smaller brains. When unborn babies had a type of congenital heart disease which did not affect cerebral substrate delivery, they showed no differences in brain growth compared to those with no congenital heart disease.

Professor Serena Counsell, Head of Advanced Neuroimaging at the Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, said: "Fetal neuroimaging enables alterations in brain development to be identified in the womb. We studied the largest sample of unborn babies with congenital heart disease reported to date and highlighted the role of cerebral oxygen and nutrient delivery in unborn baby brain growth."

Daniel Cromb, Clinical Research Fellow and PhD Student at the School of Biomedical Engineering and Imaging Sciences, said: "Understanding the biological mechanisms behind the impairments in brain development that we see in cases of congenital heart disease is important for trying to decode how and why they occur, and what we can do to prevent them occurring in the first place. Information about the types of congenital heart disease and the associated brain growth helps doctors to have discussions with women and families who are pregnant with a baby with congenital heart disease."

This research also marked a successful collaboration between King's College London and Evelina London. Over 500 women allowed their MRI scans from fetal cardiology at Evelina London to be used for this research, which took place over 8 years. The process of fetal MRI scanning was overseen by clinicians at the hospital and researchers from the School of Biomedical Engineering and Imaging Sciences.

"The process has been very helpful in highlighting the potential clinical impacts of our research," said Daniel Cromb.

David Lloyd, Clinical Research Fellow at the School of Biomedical Engineering and Imaging Sciences, and consultant in paediatric and fetal cardiology at Evelina London, said "This research highlights the amazing collaborations we have in place, using cutting-edge prenatal imaging to understand more about how the heart and brain develop together in our patients with congenital heart disease."

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