45 Using fetal ultrasound to predict developmental outcomes in children born with cardiac defects in Manitoba: A historical cohort study
Notice bibliographique
Résumé
Abstract Background The cavum septum pellucidum (CSP) is a normal anatomical cavity found in the mid-brain of the fetus and is routinely imaged at the time of mid-pregnancy obstetrical ultrasound as part of anatomic survey. Presence of the CSP reflects intact intrahemispheric connections and an intact corpus callosum. The CSP space then closes by the time of birth or early infancy, however persistence of the CSP into adulthood has been described in those with the schizophrenic phenotype of DiGeorge syndrome. Preliminary work by our group in Manitoba has shown utility in measurement of CSP width to improve non-invasive prenatal diagnosis of DiGeorge syndrome among fetuses with and without conotruncal cardiac defects. However, there exists no information about the relationship between fetal CSP width and future neurodevelopmental outcomes, such as Bayley-III scores, in children with cardiac lesions in the absence of underlying genetic comorbidities. Objectives To determine the relationship between cavum septum pellucidum (CSP) width and neurodevelopment in children born with sever cardiac defects. Design/Methods This was a historical cohort study of children born with cardiac anomalies in Manitoba (2009-2019). Eligible children with developmental pediatric follow-up between ages 18-24 months corrected age were identified using a clinical repository. Post-processing measurement of fetal CSP at mid-gestation using stored obstetrical ultrasounds was performed by two blinded and independent reviewers in a standardized fashion. Ultrasound reports were also reviewed to collate data about routine fetal biometry and imaging data then linked to demographics, birth information, surgical details and neurodevelopmental outcomes (Bayley-III scales). Linear regression models were used to evaluate the relationship between CSP width and Bayley-III scores; inferential statistics were used to compare outcomes between groups (biventricular versus single-ventricle repair). Results 78 of 111 eligible cases had stored ultrasound images and included in the analysis. Most children were delivered at term following vaginal delivery (71%), with normal birthweight and Apgars. Median CSP width was 3.8mm (SD 1.2). There was a range conotruncal cardiac anomalies and 47% required single-ventricle repair. There was no obvious relationship between CSP width and Bayley-III motor (p=0.932) or cognitive domains (p0.686), however there was a trend towards larger CSP and higher Bayley-III language scores (p=0.049). Conclusion The influence of the deoxygenated blood on the developing fetal brain in modifying outcomes for children with severe cardiac defects needs future study to improve postnatal development in this high-risk group.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».