Amanda Cao

Supervisor: Lisa Hornberger

Project: Impact of preterm birth and adverse exposures before birth on surgical outcomes for congenital heart disease


Edmonton, AB

Degree program:

Doctor of Medicine

What's been the best part of your experience so far?

So far, the best part of my experience is accompanying Dr. Hornberger and her trainees to clinics at the Stollery Children's Hospital or at the Royal Alexandra Hospital and seeing what a pediatric and fetal cardiologist does on a day to day basis. As I am so early into my medical education and not sure where I would like to take my career, having the extra exposure to different specialties, learning about patient care, and seeing what a typical day for a physician entails is a unique and valuable experience for me.

How has your studentship helped you towards your career aspirations?

My studentship has helped me towards my career aspirations because I wanted to gain a deeper understanding of how a physician incorporates research into their clinical duties. This summer, I was able to learn about clinical research and see how it influences patient care and medical decisions, as well as observe firsthand what a cardiologist does. Working with Dr. Hornberger has been an incredibly valuable opportunity for me as she is both a physician and a scientist in a field that represents an intersection between women and children's health.

Lay abstract:

Current research has suggested that suboptimal fetal environments and adverse early life exposures (AELE) may contribute to adult cardiovascular disease. Maternal diabetes, a poorly functioning placenta, and premature birth have been shown to impact heart muscle and blood vessel health in older childhood. Infants with congenital heart disease (CHD) with such AELEs have worse surgical outcomes in infancy, the cause of which has not been fully defined. Our retrospective study explores the operative outcomes following open heart surgery for infants with CHD at < 1 year of age born small due to poor placental function, to a diabetic mother or born prematurely (< 37 weeks). We will compare the outcomes with those of age-matched infants undergoing the same surgery but who were born with a normal birth weight to healthy mothers at > 37 weeks. We expect to see infants with AELEs will have worse surgical outcomes due to greater heart muscle injury in the first 24 hours after surgery, greater number of deaths and longer intensive care and hospital stays. If this proves to be true, our research will improve pre-surgery counseling—leading to novel strategies that prevent the injury and improve outcomes of affected infants.