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Published on: May 5, 2018
A new look at outcomes of infants with congenital heart disease
Annette Majnemer1, Catherine Limperopoulos, Michael I Shevell
1School of Physical and Occupational Therapy, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada. annette.majnemer@mcgill.ca
Insights
Congenital heart defects requiring surgery often lead to persistent neurologic and developmental delays in infants. Early intervention and careful planning of resources are crucial for this high-risk population.
Area of Science:
- Pediatric Cardiology
- Developmental Pediatrics
- Neurodevelopmental Disabilities
Background:
- Congenital heart defects (CHDs) are a significant concern in newborns, often necessitating complex surgical interventions.
- Infants with CHDs represent a vulnerable population with potential for neurodevelopmental challenges.
- Understanding the long-term impact of CHD and its surgical treatment on child development is critical.
Purpose of the Study:
- To longitudinally assess neurodevelopmental outcomes in infants with CHDs undergoing open-heart surgery.
- To identify factors associated with developmental trajectories in this cohort.
- To inform future research and clinical practice for optimizing care.
Main Methods:
- A longitudinal study followed 131 infants with CHDs requiring open-heart surgery.
- Evaluations were conducted pre-surgery, at discharge, 12-18 months post-surgery, and at 5 years of age.
- Data collected included medical, surgical, demographic, and environmental factors.
Main Results:
- A significant proportion of infants exhibited pre-existing neurologic and developmental abnormalities.
- Developmental delays were prevalent in both cyanotic and acyanotic CHD groups and persisted to school age.
- Multiple factors, including medical, surgical, and environmental influences, were linked to developmental outcomes, indicating a multifactorial etiology.
Conclusions:
- Developmental deficits are common in infants with CHDs and persist into early school years.
- Brain injury in this population likely results from a combination of factors.
- Enhanced planning for educational and rehabilitation services is essential for this high-risk group.
Abstract:
This article provides an overview of a longitudinal study on a cohort of 131 newborns and young infants with congenital heart defects who required open heart surgery. The rationale for the study design is provided as well as a summary of the procedures used to evaluate these children prior to surgery, at discharge after surgery, 12-18 months later, and at 5 years of age. Results demonstrate that a substantial proportion of these infants had neurologic and developmental abnormalities prior to surgical repair. Developmental delays were common in children with both cyanotic and acyanotic heart defects, and these deficits persisted to school entry. A number of medical, surgical, demographic and environmental factors were significantly associated with developmental outcomes suggesting a multifactorial etiology to brain injury. Limited educational and rehabilitation resources for this cohort at early school age suggests that service needs may need to be more carefully planned for this high-risk population. Lessons learnt from this prospective study are highlighted as well as future directions for research and clinical practice.
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