MedPath

Characterization and Support of Neurodevelopmental Disorders Associated with Congenital Cardiac MalfoRmations - Neonatal

Not yet recruiting
Conditions
Heart Disease Congenital
Neurodevelopmental Disorder
Registration Number
NCT06690151
Lead Sponsor
Nantes University Hospital
Brief Summary

Congenital heart defects (CHD), as the leading cause of birth defects, affect 12 million people globally and approximately 41,000 newborns each year in Europe. CHD presents a significant public health concern due to its association with high morbidity and mortality rates across the lifespan. Over 50% of infants born with critical CHD will develop neurodevelopmental disorders (NDD), requiring specialized care and impacting their quality of life. NDDs, involving early and persistent disruptions in cognitive, emotional, and behavioral development due to abnormal brain development, are highly variable. They may impact language, learning, motor skills, intellectual efficiency, social cognition, attention, memory, and executive functions, often accompanied by psychosocial difficulties. These hidden disabilities constitute the primary long-term sequelae of CHD, surpassing even cardiovascular complications in impact, and affect children who often undergo multiple cardiac surgeries during early childhood. NDDs are associated not only with complex CHDs but also with simpler CHDs that are repaired in early childhood and considered 'cured.'

The origin of CHD-associated NDDs remains largely unknown. While few genetic or environmental causes have been identified, recent research suggests a possible common origin linking heart malformations and neurodevelopmental abnormalities. The CATAMARAN neonatal cohort project aims to detect developmental delays associated with CHD as early as six months of age and to identify both individual susceptibility factors and acquired vulnerabilities contributing to the development of NDDs in infants with CHD.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
450
Inclusion Criteria

Not provided

Exclusion Criteria
  • Medical termination of pregnancy considered
  • Genetic anomaly or malformative syndrome identified prior to inclusion

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Evaluate the prevalence of developmental delays in infants with a critical congenital heart defect (CHD) at 6 months of age.6 months
Secondary Outcome Measures
NameTimeMethod
Evaluate the prevalence of developmental delay in infants with congenital heart defects (CHD) based on the type of heart defect.6 months
Assess the presence of developmental delay in infants with CHD based on the complexity of cardiac surgery.6 months
Evaluate and describe affected developmental domains.6 months
Identify rare genetic variants associated with developmental delays in CHD patients through genome-wide analysis.6 months
Identify common genetic variants associated with developmental delays in CHD patients through genome-wide analysis.6 months
Characterize placental anatomopathological anomalies in CHD and their correlation with developmental delay at 6 months.6 months
Determine maternal dietary habits during the third trimester, their correlation with placental anomalies, and developmental delay at 6 months.6 months
Characterize maternal behavioral exposures (e.g., tobacco, alcohol, drugs) and obstetric complications (e.g., hypertension, preeclampsia, gestational diabetes) during pregnancy, and their correlation with placental anomalies and developmental delay6 months
Characterize antenatal determinants of developmental delay through multi-omics analysis (metabolomics, lipidomics, transcriptomics, and epigenetics) of maternal blood, placental function, and fetal blood, and their correlation with developmental delay6 months
Characterize neonatal microbiota and its association with developmental delay at 6 months.6 months
Identify perioperative determinants of developmental delay in CHD.6 months
Identify optimal perfusion pressure targets during and after neonatal cardiac surgery under cardiopulmonary bypass in three participating centers using continuous analysis of invasive blood pressure and cerebral oxygen saturationup to 3 months
For CHU Nantes patients only: identify fetal neuronal biomarkers at birth, track their evolution before and after cardiac surgery in CHD infants, and establish associations with developmental delay at 6 months.6 months
Evaluate parental post-traumatic stress at 1) antenatal inclusion, 2) perioperative period, and 3) 6 months post-surgery, and its correlation with developmental delay at 6 months.6 months

Trial Locations

Locations (1)

Nantes University Hospital

🇫🇷

Nantes, Loire Atlantique, France

© Copyright 2025. All Rights Reserved by MedPath