Neonatal brain structure, cognitively stimulating parenting and behavioural outcomes in preschool children with congenital heart disease and controls

Neonatal brain structure, cognitively stimulating parenting and behavioural outcomes in preschool children with congenital heart disease and controls | Research Square Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Article Neonatal brain structure, cognitively stimulating parenting and behavioural outcomes in preschool children with congenital heart disease and controls Barat Gal-Er, Alexandra F. Bonthrone, Andrew T.M. Chew, Sian Wilson, and 11 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8871133/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 29 May, 2026 Read the published version in Scientific Reports → Version 1 posted 12 You are reading this latest preprint version Abstract Children with congenital heart disease (CHD) are at increased risk of altered early brain development and neurodevelopmental impairments. However, the interplay between neonatal brain structure and the home environment in shaping behavioural outcomes remains unclear. We investigated associations between neonatal structural covariance networks (SCNs), cognitively stimulating parenting, and behavioural outcomes at 4-6 years in 44 preschool children with CHD and 117 controls. Principal component analysis was performed on 19 items drawn from six parent-reported questionnaires to identify distinct components of childhood behaviour. Parents completed the cognitively stimulating parenting scale (CSPS) to assess cognitive stimulation at home. Forty SCNs were extracted from Jacobian determinants of neonatal T2-weighted MRI using independent component analysis. In children with CHD, anterior thalamus and cingulum morphometry was associated with empathy in childhood. Higher CSPS scores were associated with fewer neurodevelopmental difficulties in CHD, but not controls. In both groups, CSPS moderated the relationship between superior temporal gyrus morphometry and empathy while, in CHD only, CSPS moderated the relationship between inferior temporal gyrus morphometry and empathy. These findings identify early neurobiological and environmental determinants of behavioural outcomes in children with CHD and highlight the home environment as a modifiable factor in supporting neurodevelopment in this population. Health sciences/Diseases Health sciences/Medical research Biological sciences/Neuroscience congenital heart disease neonatal brain MRI structural covariance neurodevelopmental outcomes Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementarymaterialsGalEr.docx Cite Share Download PDF Status: Published Journal Publication published 29 May, 2026 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Revision requested 07 Apr, 2026 Reviews received at journal 03 Apr, 2026 Reviews received at journal 01 Apr, 2026 Reviewers agreed at journal 25 Mar, 2026 Reviewers agreed at journal 22 Mar, 2026 Reviewers agreed at journal 20 Mar, 2026 Reviewers agreed at journal 09 Mar, 2026 Reviewers invited by journal 06 Mar, 2026 Editor assigned by journal 06 Mar, 2026 Editor invited by journal 24 Feb, 2026 Submission checks completed at journal 19 Feb, 2026 First submitted to journal 19 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information

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