MATERNAL HYPEROXYGENATION IN CONGENITAL HEART DISEASE (MATCH)

Looking back:
our work in Phase 1

In CHILD-BRIGHT’s Phase 1, the MATCH project team tested whether giving mothers supplemental oxygen in the third trimester improved the brain development of their infant with congenital heart disease (CHD). For the chronic hyperoxygenation arm of our study, in which we provide moms with supplemental oxygen throughout the third trimester, our preliminary analysis of 20 participants (of a planned total sample size of 30) has yielded promising results. We are excited to report that the newborns have lower rates of brain injury compared to a control group of newborns with heart disease who were not supplemented with oxygen during pregnancy. In fact, only one of the babies in our study had a mild brain injury, while in the control group, brain injury was present in around 28% of newborns. Our mothers found the oxygen tolerable, and the treatment was not associated with any serious adverse events. We have observed a modest reduction in birthweight in our babies, on average 260 g, which could be an unwanted effect of the treatment. 

In the acute hyperoxygenation arm of our study, we provide pregnant moms with supplemental oxygen while doing medical imaging. This allows us to better understand the impact of the oxygen on blood flow around the fetus and how much oxygen reaches the fetus’ brain. For this arm, recruitment is ongoing to reach our target of 150 participants. 

Overall, we are learning important information about the effect of supplemental oxygen, which is of interest to those considering this as a strategy to protect the brain in the setting of congenital heart disease. Some of the feedback we have received from mothers participating in the study includes: “It has been a truly rewarding and positive experience to participate in the MATCH research study. My son Henry has greatly benefited from this early intervention. […] Thank you for your passion and dedication to research, and for serving and caring for children like our sweet Henry.” – Jamie, mom of Henry (age 2.5 years old). We’ve worked hard to disseminate these exciting early findings. Our team has published six peer reviewed articles and one book chapter, while our trainees have presented our work at four scientific conferences. Our patient-partners continue to offer invaluable support to the mothers who enrol in the study.  

An eye to the future: what Phase 2 has in store for us

In the process of undertaking the MATCH study, we have noted rather low rates of neurodevelopmental follow-up in children with CHD. This is in keeping with other recent research, indicating that the neurodevelopmental needs of children with heart disease are underserved. In line with CHILD-BRIGHT’s priorities for Phase 2, we are now planning to explore implementation science practices that might be employed to improve neurodevelopment follow-up practices of babies with CHD in Canada. Babies with significant heart disease require periodic neurodevelopmental assessments to identify developmental delays and treatments in a timely fashion. In Phase 2, we will study how to improve health services such that the patients with CHD who require neurodevelopmental assessments receive them. 

We’re excited to tackle this next phase and continue helping babies with CHD and their families. To quote the words of Jamie, one of the mothers in our study, “Put your sunglasses on, because the future is bright!”