{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T03:46:00Z","timestamp":1790567160365,"version":"4.1.0"},"reference-count":59,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,27]],"date-time":"2019-12-27T00:00:00Z","timestamp":1577404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Neurodevelopmental delay is frequently encountered in children with a congenital heart defect (CHD). Fetuses with major CHD have a smaller head circumference (HC), irrespective of altered cerebral flow or brain oxygenation. This cohort study compared head growth in cases with isolated <jats:italic>vs<\/jats:italic> those with non\u2010isolated CHD to evaluate the effect of additional pathology on head size in these fetuses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>All CHD cases diagnosed prenatally in the period January 2002\u2013July 2014 were selected from our regional registry, PRECOR. Cases of multiple pregnancy, and those affected by maternal diabetes, severe fetal structural brain anomalies or functional CHD were excluded. Subjects were divided into groups according to whether the CHD was isolated, and the non\u2010isolated group was subdivided into three groups: cases with genetic anomaly, extracardiac malformation or placental pathology. In both isolated and non\u2010isolated CHD groups, CHDs were also grouped according to their potential effect on aortic flow and oxygen saturation. Mean HC <jats:italic>Z<\/jats:italic>\u2010scores at 20\u2009weeks and increase or decrease (\u0394) of HC <jats:italic>Z<\/jats:italic>\u2010scores over the course of pregnancy were compared between isolated and non\u2010isolated groups, using mixed linear regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Included were 916 cases of CHD diagnosed prenatally, of which 378 (41.3%) were non\u2010isolated (37 with placental pathology, 217 with genetic anomaly and 124 with extracardiac malformation). At 20\u2009weeks, non\u2010isolated cases had significantly lower HC <jats:italic>Z<\/jats:italic>\u2010scores than did isolated cases (<jats:italic>Z<\/jats:italic>\u2010score\u2009=\u2009\u20130.70 <jats:italic>vs<\/jats:italic> \u20130.03; <jats:italic>P\u2009&lt;<\/jats:italic>\u20090.001) and head growth over the course of pregnancy showed a larger decrease in this group (\u0394 HC <jats:italic>Z<\/jats:italic>\u2010score\u2009=\u2009\u20130.03 <jats:italic>vs<\/jats:italic> \u20130.01 per week; <jats:italic>P<\/jats:italic>\u2009=\u20090.01). Cases with placental pathology had the lowest HC <jats:italic>Z<\/jats:italic>\u2010score at 20\u2009weeks (<jats:italic>Z<\/jats:italic>\u2010score\u2009=\u2009\u20131.29) and the largest decrease in head growth (\u0394 HC <jats:italic>Z<\/jats:italic>\u2010score\u2009=\u2009\u20130.06 per week). In CHD subjects with a genetic diagnosis (<jats:italic>Z<\/jats:italic>\u2010score\u2009=\u2009\u20130.73; \u0394 HC <jats:italic>Z<\/jats:italic>\u2010score\u2009=\u2009\u20130.04 per week) and in those with an extracardiac malformation (<jats:italic>Z<\/jats:italic>\u2010score\u2009=\u2009\u20130.49; \u0394 HC <jats:italic>Z<\/jats:italic>\u2010score\u2009=\u2009\u20130.02 per week), HC <jats:italic>Z<\/jats:italic>\u2010scores were also lower compared with those in subjects with isolated CHD. CHDs that result in low oxygenation or flow to the brain were present more frequently in isolated than in non\u2010isolated cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Smaller HC in fetuses with CHD appears to be associated strongly with additional pathology. Placental pathology and genetic anomaly in particular seem to be important contributors to restricted head growth. This effect appears to be irrespective of altered hemodynamics caused by the CHD. Previously reported smaller HC in CHD should, in our opinion, be attributed to additional pathology. Neurodevelopment studies in infants with CHD should, therefore, always differentiate between isolated and non\u2010isolated cases. \u00a9 2019 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.20260","type":"journal-article","created":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T02:48:45Z","timestamp":1552531725000},"page":"217-225","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Impact of extracardiac pathology on head growth in fetuses with congenital heart defect"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1752-5834","authenticated-orcid":false,"given":"A. E. L.","family":"van Nisselrooij","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5258-1957","authenticated-orcid":false,"given":"F. A. R.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"van Geloven","sequence":"additional","affiliation":[{"name":"Medical Statistics Department of Biomedical Data Sciences, Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. H.","family":"Linskens","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Obstetrics, Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Pajkrt","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Obstetrics, Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5276-1475","authenticated-orcid":false,"given":"S.\u2010A.","family":"Clur","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology Emma Children's Hospital, University Medical Center Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. A.","family":"Rammeloo","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology Emma Children's Hospital, University Medical Center Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Rozendaal","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M. M.","family":"van Lith","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. A.","family":"Blom","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0443-1997","authenticated-orcid":false,"given":"M. C.","family":"Haak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01886-7"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951114001140"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezv029"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1959"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.06.063"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12526"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.125227"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073811402073"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.547961"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.03.029"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14881"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15980"},{"key":"e_1_2_6_14_1","first-page":"453","article-title":"Head size at birth in neonates with transposition of great arteries and hypoplastic left heart syndrome","volume":"26","author":"Manzar S","year":"2005","journal-title":"Saudi Med J"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13373"},{"key":"e_1_2_6_16_1","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1161\/CIRCULATIONAHA.115.019089","article-title":"Congenital Heart Defects and Indices of Fetal Cerebral Growth in a Nationwide Cohort of 924 422 Liveborn Infants","volume":"133","author":"Matthiesen NB","year":"2016","journal-title":"Circulation"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2009.09.004"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19102"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008771"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15970"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951107000248"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1132-6"},{"key":"e_1_2_6_23_1","doi-asserted-by":"crossref","unstructured":"Carvalho JS.Re: Head growth in fetuses with isolated congenital heart defects: lack of influence of aortic arch flow and ascending aorta oxygen saturation. F. A. R. Jansen E. W. van Zwet M. E. B. Rijlaarsdam E. Pajkrt C. L. van Velzen H. R. Zuurveen A. Kragt C. L. Bax S.\u2010A. B. Clur J. M. M. van Lith N. A. Blom and M. C. Haak.Ultrasound Obstet Gynecol2016;48: 357\u2013364 [Refereree Commentary].Ultrasound Obstet Gynecol2016;48: 282.","DOI":"10.1002\/uog.15980"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13274"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5225"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15742"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.12.023"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000126245.35811.2a"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1887021"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1159\/000486094"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-002-0404-0"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1159\/000330202"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14677"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2013.61"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e3181827bf4"},{"key":"e_1_2_6_36_1","unstructured":"WolfH. Foetale groeibeperking Versie 2 1: NVOG Nederlandse Vereniging voor Obstetrie & Gynaecologie2008; 25."},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5242"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.82.1.83"},{"key":"e_1_2_6_39_1","first-page":"249","article-title":"Birthweight of infants with congenital heart disease","volume":"132","author":"Levy RJ","year":"1978","journal-title":"Am J Dis Child"},{"key":"e_1_2_6_40_1","article-title":"Placenta\u2010related complications in women carrying a foetus with congenital heart disease","volume":"29","author":"Ruiz A","year":"2016","journal-title":"J Matern Fetal Neonatal Med"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.16.04023"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-018-1876-x"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht389"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12346"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/7.2.205"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0143-4004(96)80004-X"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgen.0030140"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1242\/dev.127.18.3941"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2012.05.014"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1038\/87904"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1038\/8379"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-1596-5-24"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6244"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI17189"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414838"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.22395"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2017.275"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ydbio.2010.08.030"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm819"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.1203\/PDR.0b013e3181c2dc76"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.20260","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20260","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.20260","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.20260","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T09:43:13Z","timestamp":1694166193000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.20260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,27]]},"references-count":59,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1002\/uog.20260"],"URL":"https:\/\/doi.org\/10.1002\/uog.20260","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,27]]},"assertion":[{"value":"2018-08-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}