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Effect of congenital heart disease on neurodevelopmental outcomes within multiple-gestation births
Amy H Schultz1, Gail P Jarvik, Gil Wernovsky
1Division of Cardiology, The Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, Pa, USA. ahschultz@uwalumni.com
Insights
Infants with congenital heart disease needing surgery before six months had lower cognitive and motor scores at one year. This study controlled for factors like prematurity and socioeconomic status, highlighting developmental impacts.
Area of Science:
- Pediatric Cardiology
- Developmental Pediatrics
- Neonatology
Background:
- Congenital heart disease (CHD) is a significant concern in pediatric health.
- Surgical intervention with cardiopulmonary bypass is common for severe CHD in infants.
- The long-term developmental impact of early-life CHD requires thorough investigation.
Purpose of the Study:
- To evaluate the effect of early-life CHD requiring cardiopulmonary bypass on infant development and growth.
- To control for confounding variables including socioeconomic status, prematurity, home environment, and parental intelligence.
Main Methods:
- Within-family comparison of multiple-gestation births (n=11) where one sibling had CHD.
- Assessment of developmental outcomes using the Bayley Scales of Infant Development II at 1 year of age.
- Evaluation of growth parameters (weight, height, head circumference) at 1 year.
Main Results:
- Children with CHD scored significantly lower on the Mental Development Index (P = .037) and Psychomotor Development Index (P = .015) compared to their siblings.
- No significant differences were observed in weight, height, or head circumference between siblings.
- Subjects were mildly premature on average (mean gestational age 35.4 weeks).
Conclusions:
- Early-life CHD requiring surgical intervention is associated with deficits in cognitive and psychomotor development at 1 year of age.
- The findings underscore the importance of neurodevelopmental follow-up for infants with CHD.
- Growth parameters were not affected, suggesting a specific impact on developmental domains.
Objectives:
We sought to assess the effect of congenital heart disease requiring surgical intervention with cardiopulmonary bypass at 6 months of age or less on developmental outcomes and growth at 1 year of age while controlling for socioeconomic status, prematurity, home environment, and parental intelligence.
Methods:
We performed within-family comparison of 11 multiple-gestation births in which one child had congenital heart disease. At 1 year of age, the Bayley Scales of Infant Development II were administered, and growth parameters were assessed. Paired comparisons were made by using fixed effects regression conditioned on family.
Results:
The multiple-gestation subjects were mildly premature on average (mean gestational age, 35.4 +/- 3.0 weeks). At 1 year of age, children with congenital heart disease scored lower on the Mental Development Index (85.0 +/- 19.3 vs 93.9 +/- 16.0, P = .037) and the Psychomotor Development Index (76.6 +/- 16.9 vs 91.3 +/- 14.9, P = .015) on the Bayley Scales of Infant Development II than did their siblings without congenital heart disease. There were no differences between siblings in weight, height, or head circumference.
Conclusions:
The presence of congenital heart disease requiring surgical intervention with cardiopulmonary bypass at 6 months of age or less is associated with a deficit in developmental achievement at 1 year of age, as measured by using the Bayley Scales of Infant Development II.
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