Brain metabolite concentrations in neonates with congenital heart disease before and after cardiac surgery.

The purpose of this study was to compare brain metabolite concentrations between healthy and CHD neonates before and after cardiac surgery. Healthy term newborns and neonates with CHD were recruited prospectively. T-weighted brain images and MRS data were acquired in the cerebellum, right frontal lobe and basal ganglia.

Directional flow of brain connections and neurodevelopmental outcomes in healthy full-term newborns.

Objective: We examined whether directional flow among brain hubs in healthy-term infants is associated with neurodevelopmental outcomes at two years of age.

Methods: High-density electroencephalography (EEG) was collected within 72 h after birth. Neurodevelopmental outcomes (cognitive, language, and motor scores) were measured using Bayley Scales of Infant Development-III (BSID-III) at two years.

Measures of Brain Metabolism and Diffusion in Neonates of Diabetic Mothers.

Background And Purpose: Maternal diabetes may affect newborns' long-term neurodevelopment and cognitive behavior. Brain biochemistry and white matter fiber tracks may reveal early changes of brain abnormality. The purpose of this study was to compare brain metabolites and fiber structures in infants of diabetic mothers (IDMs) with those of non-diabetic mothers during the early stage of neonatal neurodevelopment.

Altered brain state dynamics between preterm and term-born infants.

Preterm birth alters the development of infant brain networks. However, most prior studies investigate its effects on static brain networks rather than dynamic brain states. Increasing evidence shows that brain state dynamics reflect cognitive processes beyond what is revealed by static brain networks.

Tobacco and cannabis use among pregnant women with prenatal opioid use.

Background: There is a paucity of information on tobacco and cannabis use patterns in pregnant women who use opioids. Our objective was to examine sociodemographic, tobacco, and cannabis use patterns during pregnancy among pregnant women with opioid use.

Methods: We recruited 206 pregnant women with biochemically verified opioid use during pregnancy, of whom 98 self-reported taking only medications for opioid use disorder (MOUD) and 108 reported taking other opioids during pregnancy.

Epigenomic signatures of accelerated epigenetic aging are associated with congenital heart disease in newborns.

Background: Congenital heart disease (CHD) lesions are the most common birth defects and despite advances in care, are associated with short- and long-term co-morbidities. The exact mechanisms that may influence outcomes in survivors with CHD remain unclear and are likely multi-factorial; exploring the epigenome in these cases may provide novel insights into predictive biomarkers contributing to outcomes. The present study characterizes the impact of CHD on the newborn epigenome through assessments of epigenetic age.

Early parenteral lipid intake supports cerebellar neurometabolism at term-age in preterm infants.

Objectives: The impact of crucial early parenteral nutrition on neurometabolism of the preterm brain remains unclear. This study characterizes the relationship of parenteral lipid and caloric intake with cerebellar neurometabolites.

Methods: Very premature infants [born ≤32-week gestational age (GA)] in a prospective observational cohort study underwent a proton magnetic resonance spectroscopy (H-MRS) acquisition from a cerebellar voxel at term-age.

Prenatal Opioid Exposure Is Associated with Punctate White Matter Lesions in Term Newborns.

Objective: To assess whether prenatal opioid exposure is associated with punctate white matter lesions (PWMLs) on brain magnetic resonance imaging (MRI) in a large prospective cohort of term newborns.

Study Design: Newborns ≥37 weeks of gestation with prenatal opioid exposure and unexposed controls underwent brain MRI at 0-1 months of age in the prospective observational Outcomes of Babies with Opioid Exposure study. Exposure status was based on maternal self-report and maternal or neonatal toxicology screening.

Protocol for a randomized controlled trial of the Mommy&Me study: A multi-modal approach to address social determinants of health and mental health among low-income Black perinatal populations.

Background: Mental health disorders, including stress, anxiety, and depression, are the most common complications during pregnancy, with significant racial disparities in prevalence and access to care. Low-income Black/African American/of African descent (Black) individuals are at greater risk for perinatal mental health issues and face more obstacles to care due to a variety of barriers, including poor implementation of screening protocols, stigma, adverse experiences of social determinants of health, and distrust of healthcare systems. These disparities are particularly striking in Washington, DC, and worsened during the COVID-19 pandemic.

Placental and Fetal In Utero Growth Among Fetuses With Congenital Heart Disease.

Importance: At birth, neonates with congenital heart disease (CHD) have smaller placentas, lower birth weight, and smaller head circumferences compared with healthy neonates. The onset of feto-placental growth disturbances, however, is not well known.

Objective: To compare fetal body volumes, assess differences in the fetal to placental volume ratios (placental growth relative to the fetus), and investigate the association between in utero fetal body and total brain volume in fetuses with and without CHD.

Evaluating the effects of volume censoring on fetal functional connectivity.

Advances in neuroimaging have enabled non-invasive investigation of fetal brain development in vivo. Resting-state functional magnetic resonance imaging (rs-fMRI) has provided critical insights into emerging brain networks in fetuses. However, acquiring high-quality fetal rs-fMRI remains challenging due to the unpredictable and unconstrained motion of the fetal head.

Antenatal Opioid Exposure and Global and Regional Brain Volumes in Newborns.

Importance: Although antenatal opioid exposure is associated with impaired brain growth, previous studies are limited by small sample sizes and lack of controls. As a result, the impacts of opioid exposure on the developing brain remain poorly understood.

Objective: To compare global, regional, and tissue-specific brain volumes in opioid-exposed newborns vs unexposed controls.

Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy and unexposed controls.

Background: Food insecurity during pregnancy is associated with poorer outcomes for both mothers and their newborns. Given the ongoing opioid crisis in the United States, mothers who take opioids during pregnancy may be at particular risk of experiencing food insecurity.

Methods: This research utilized data from 254 biological mothers of infants in the Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW) Outcomes of Babies with Opioid Exposure (OBOE) Study.

Neurobehavioral Profiles in Opioid-Exposed and Unexposed Neonates.

Objective: To describe distinctive profiles of neurobehavior in opioid-exposed and unexposed neonates.

Study Design: The Outcomes of Babies with Opioid Exposure study is a multisite, prospective, observational study in neonates born at term with opioid exposure and unexposed controls. As part of the Outcomes of Babies with Opioid Exposure study protocol, certified examiners administered the NeoNatal Neurobehavioral Scales, second edition (NNNS-II) before 6 weeks postnatal age.

Brainstem and Deep Gray Nuclei Modulate Brain Network Efficiency in Low-risk Term Newborns.

In low-risk term newborns, network analysis of source EEG has identified the hub regions that play an important role in information transfer in the network. However, the network efficiency changes after removing particular hub regions are not yet clear. The resting state 124channel high-density electroencephalography (HD-EEG) was collected from low-risk term newborns within 72 hours after birth.

Supplementing Consent for a Prospective Longitudinal Cohort Study of Infants With Antenatal Opioid Exposure: Development and Assessment of a Digital Tool.

Background: The Outcomes of Babies With Opioid Exposure (OBOE) study is an observational cohort study examining the impact of antenatal opioid exposure on outcomes from birth to 2 years of age. COVID-19 social distancing measures presented challenges to research coordinators discussing the study at length with potential participants during the birth hospitalization, which impacted recruitment, particularly among caregivers of unexposed (control) infants. In response, the OBOE study developed a digital tool (consenter video) to supplement the informed consent process, make it more engaging, and foster greater identification with the research procedures among potential participants.

Placental quantitative susceptibility mapping and T2* characteristics for predicting birth weight in healthy and high-risk pregnancies.

Background: The human placenta is critical in supporting fetal development, and placental dysfunction may compromise maternal-fetal health. Early detection of placental dysfunction remains challenging due to the lack of reliable biomarkers. This study compares placental quantitative susceptibility mapping and T2* values between healthy and high-risk pregnancies and investigates their association with maternal and fetal parameters and their ability to predict birth weight (BW).

Lessons Learned in Virtual Launch of an Antenatal Opioid Exposure Study During the COVID-19 Pandemic.

Background: The COVID-19 pandemic prompted researchers to develop new ways to design and launch studies and recruit and retain participants. Pregnant women and infants are considered vulnerable populations in research, and families affected by substance use are particularly difficult to recruit and retain. Recruitment for studies involving medical technologies such as MRI can also be difficult due to misconceptions and fear of the technologies.

The Role of Proton Magnetic Resonance Spectroscopy in Neonatal and Fetal Brain Research.

The biochemical composition and structure of the brain are in a rapid change during the exuberant stage of fetal and neonatal development. H-MRS is a noninvasive tool that can evaluate brain metabolites in healthy fetuses and infants as well as those with neurological diseases. This review aims to provide readers with an understanding of 1) the basic principles and technical considerations relevant to H-MRS in the fetal-neonatal brain and 2) the role of H-MRS in early fetal-neonatal development brain research.

Third-Trimester Development of Central Autonomic Network Connectivity Is Altered in an Extrauterine Environment.

Introduction: The central autonomic network (CAN), which involves complex interconnected brain regions that modulate the autonomic nervous system, may be key to understanding higher risk for psychosocial and behavioral challenges in preterm neonates.

Methods: We compared resting-state functional connectivity of the CAN in 94 healthy term-born controls and 94 preterm infants at term-equivalent age. In preterm infants, we correlated CAN connectivity with postmenstrual age (PMA).

Brain development using a multicomponent intravenous lipid emulsion in preterm infants.

Background: Intravenous lipid emulsions are an essential component of nutritional support for very preterm infants. Many neonatal intensive care units have transitioned from traditional soybean oil-only to fish oil-containing multicomponent lipid emulsions, but the neurodevelopmental implications have not been well-explored. The primary aim of this study was to assess extrauterine third trimester brain growth in very preterm infants supported with soybean oil-only compared to fish-oil containing multicomponent lipid emulsions; white matter development and neurobehavioral regulation at term were also investigated.

Term infant brain MRI after ROP treatment by anti-VEGF injection versus laser therapy.

Background: Intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents is used to treat posterior type 1 retinopathy of prematurity (ROP). Recent reports indicate that anti-VEGF therapy may be associated with white matter brain injury, according to animal studies, and neurodevelopmental impairments in children born preterm. We investigated whether type 1 ROP treated with bevacizumab is associated with structural brain injury on infant term magnetic resonance images (MRIs) in very low birth weight infants compared with those treated with laser ablation.

Asymmetry of Directed Brain Connectivity at Birth in Low-Risk Full-Term Newborns.

Purpose: Functional connectivity hubs were previously identified at the source level in low-risk full-term newborns by high-density electroencephalography (HD-EEG). However, the directionality of information flow among hubs remains unclear. The aim of this study was to study the directionality of information flow among source level hubs in low-risk full-term newborns using HD-EEG.

Single vs. multi-slice assessments of in vivo placental T2∗ measurements.

Introduction: Placental health is vital for maternal and fetal well-being, and placental T2∗ has been suggested to identify in vivo placental dysfunction prior to delivery. However, ideal regions of interest to best inform functional assessments of the placenta remain unknown. The aim of this study is to compare global and slice-wise measures of in-vivo placental T2∗ assessments.

Technical considerations for placental tissue processing and the subsequent impact on genome-wide DNA methylation analysis.

To assess the impact of postnatal processing on placental DNA methylation, array data from flash-frozen placental tissue was compared to perfluorocarbon-immersed and formalin-fixed paraffin-embedded placental tissue. We observed that tissue exposed to perfluorocarbon showed no significant DNA methylation differences when compared to unprocessed tissue, while formalin processing altered the quality and reliability of the data produced on the DNA methylation array platform. Placental DNA methylation allows for the study of gene-environment interactions that influence the fetal environment and development.