# The Risk of Acquired Neonatal Significant brain Injury during perinatal Transition in Congenital Heart Disease: TRANSIT CHD study

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $582,119

## Abstract

ABSTRACT
Severe forms of congenital heart disease such as transposition of the great arteries (TGA) are common birth
defects. Outcomes for TGA have significantly improved with restoration of normal cardiovascular physiology
after the newborn operation. Despite this, children with TGA experience significant neurodevelopmental (ND)
impairments across the lifespan suggesting that prenatal and neonatal physiology may have a lasting impact
on ND outcome. Newborns with TGA are known to have delayed brain development beginning in utero and are
at increased risk for acquired neonatal white matter injury (WMI) with the majority observed before the
neonatal operation. These observations and our preliminary data suggest that circulatory adjustments during
perinatal transition from fetal to neonatal life may play a significant role in the susceptibility to WMI after birth.
Perinatal transition is a key time period with potential for neuroprotective interventions such as delayed cord
clamping, which has been demonstrated to provide neuroprotection to term and preterm newborns. In this
proposal, we aim to fill a significant gap in our field related to how physiologic changes in cardiovascular and
cerebral hemodynamics during perinatal transition affect brain health in patients with TGA. Our two centers’
experience with fetal and neonatal neuroimaging and neuromonitoring, uniquely positions us to take a
longitudinal approach beginning in fetal life to first identify a prenatal biomarker of poor brain maturation and
second to examine the impact of transitional physiology on acquired neonatal WMI. We will test the
hypotheses that decreased cerebral tissue oxygenation in utero predisposes to brain immaturity, that the
resulting immaturity increases susceptibility to acquired neonatal WMI due to perinatal circulatory features of
TGA, and that this could be modified by improving perinatal cerebral oxygen delivery through delayed cord
clamping. Our long term goals are to use data from this proposal to design neuroprotective trials focused on
the transitional time period that have the potential to optimize ND outcomes in this patient population.

## Key facts

- **NIH application ID:** 10345355
- **Project number:** 1R01NS125404-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Shabnam Peyvandi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $582,119
- **Award type:** 1
- **Project period:** 2022-05-01 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10345355

## Citation

> US National Institutes of Health, RePORTER application 10345355, The Risk of Acquired Neonatal Significant brain Injury during perinatal Transition in Congenital Heart Disease: TRANSIT CHD study (1R01NS125404-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10345355. Licensed CC0.

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