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.

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.

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.

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.

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).

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.

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.

Circadian rhythm development in preterm infants. The role of postnatal versus postmenstrual age.

Background, Aims: Circadian rhythm maturation may be disturbed in premature infants undergoing neonatal intensive care. We used continuous heart rate recordings across the entire neonatal intensive care period to study circadian rhythm development in preterm infants and to evaluate the roles of postmenstrual (PMA) versus postnatal age (PNA).

Materials And Methods: The circadian rhythm was calculated using a cosine fit of heart rate.

Prenatal Maternal Psychological Distress During the COVID-19 Pandemic and Newborn Brain Development.

Importance: Elevated maternal psychological distress during pregnancy is associated with altered fetal brain development. During the COVID-19 pandemic, prenatal maternal psychological distress more than doubled.

Objective: To examine the association of the pandemic and rising maternal psychological distress with brain growth in newborns using quantitative 3-dimensional volumetric magnetic resonance imaging (MRI).

Regional homogeneity as a marker of sensory cortex dysmaturity in preterm infants.

Atypical perinatal sensory experience in preterm infants is thought to increase their risk of neurodevelopmental disabilities by altering the development of the sensory cortices. Here, we used resting-state fMRI data from preterm and term-born infants scanned between 32 and 48 weeks post-menstrual age to assess the effect of early ex-utero exposure on sensory cortex development. Specifically, we utilized a measure of local correlated-ness called regional homogeneity (ReHo).

Intrauterine exposure to SARS-CoV-2 infection and early newborn brain development.

Epidemiologic studies suggest that prenatal exposures to certain viruses may influence early neurodevelopment, predisposing offspring to neuropsychiatric conditions later in life. The long-term effects of maternal COVID-19 infection in pregnancy on early brain development, however, remain largely unknown. We prospectively enrolled infants in an observational cohort study for a single-site study in the Washington, DC Metropolitan Area from June 2020 to November 2021 and compared these infants to pre-pandemic controls (studied March 2014-February 2020).

Experience of early-life pain in premature infants is associated with atypical cerebellar development and later neurodevelopmental deficits.

Background: Infants born very and extremely premature (V/EPT) are at a significantly elevated risk for neurodevelopmental disorders and delays even in the absence of structural brain injuries. These risks may be due to earlier-than-typical exposure to the extrauterine environment, and its bright lights, loud noises, and exposures to painful procedures. Given the relative underdeveloped pain modulatory responses in these infants, frequent pain exposures may confer risk for later deficits.

Improving Prenatal Palliative Care Consultation Using Diagnostic Trigger Criteria.

Background: Three percent of pregnancies are complicated by congenital anomalies. Prenatal integration of pediatric palliative care (PPC) may be hindered by non-standardized PPC referral processes. This quality improvement (QI) project aimed to improve prenatal PPC consultation using a diagnostic trigger list.

Magnetic Resonance Spectroscopy of Brain Metabolism in Fetuses With Congenital Heart Disease.

Background: Congenital heart disease (CHD) remains a significant risk factor for neurologic injury because altered fetal hemodynamics may be unable to support typical brain development during critical periods of growth and maturation.

Objectives: The primary objective was to assess differences in the cerebral biochemical profile between healthy fetuses and fetuses with complex CHD and to relate these with infant outcomes.

Methods: Pregnant participants underwent fetal magnetic resonance imaging with cerebral proton magnetic resonance spectroscopy acquisitions as part of a prospective observational study.