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Neurodevelopment in 1-year-old Japanese infants after congenital heart surgery
Tachiyo Matsuzaki1, Mie Matsui, Fukiko Ichida
1Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Japan. tmtzk@hsp.ncvc.go.jp
Insights
Infants undergoing open heart surgery for congenital heart disease show lower neurodevelopmental function, particularly gross motor skills. Longer intensive care unit stays are linked to poorer cognitive development in these infants.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Pediatrics
- Congenital Heart Disease
Background:
- Congenital heart disease (CHD) affects numerous infants globally.
- Open heart surgery is a common intervention for CHD.
- Neurodevelopmental outcomes post-surgery require thorough evaluation.
Purpose of the Study:
- To assess neurodevelopmental sequelae in 1-year-old infants after open heart surgery for CHD.
- To evaluate the Bayley Scales of Infant Development-II (BSID-II) in Japanese infants.
- To identify risk factors associated with neurodevelopmental deficits.
Main Methods:
- The study assessed 39 infants post-ventricular septal defect repair and 108 normal Japanese infants.
- The Bayley Scales of Infant Development-II (BSID-II) was used for neurodevelopmental assessment.
- Statistical analyses, including linear regression, were employed.
Main Results:
- Japanese infants with CHD showed significantly lower BSID-II scores compared to controls, especially in gross motor development.
- The BSID-II proved applicable and useful in Japanese infants.
- Extended intensive care unit (ICU) stay correlated with impaired cognitive development (P=0.03).
Conclusions:
- Infants with CHD undergoing open heart surgery exhibit deficits in neurodevelopmental function, particularly gross motor skills.
- Length of ICU stay is a significant risk factor for neurodevelopmental sequelae.
- The BSID-II is a valuable tool for assessing neurodevelopment in this population.
Background:
The purpose of this study was to determine the prevalence of persistent neurodevelopmental sequelae in 1-year-old infants after open heart surgery for congenital heart disease, using the Bayley Scales of Infant Development second edition (BSID-II). A secondary objective was to confirm the applicability and usefulness of the BSID-II in Japanese infants.
Methods:
Thirty-nine infants who underwent repair of a ventricular septal defect before 6 months of age and 108 normal Japanese infants at 1 year of age were assessed using the BSID-II.
Results:
In normal infants, scores on the Mental Development Index and the Psychomotor Development Index components of the BSID-II ranged from borderline retardation to very superior following a normal distribution similar to those obtained for US controls. No problems were encountered, either in translation or in following the instructions when the BSID-II was used to evaluate the 1-year-old Japanese infants. On the other hand, the mean scores on the Mental Development Index and the Psychomotor Development Index were significantly lower in Japanese patients than in normal Japanese infants, particularly for gross motor development (P < 0.001). Linear regression analysis showed that a longer intensive care unit stay was associated with impaired cognitive development at 1 year of age (P= 0.03).
Conclusions:
Neurodevelopmental functions in 1-year-old infants with congenital heart disease were lower than those in normal infants, especially for gross motor function using the BSID-II. One risk factor that correlated with neurodevelopmental sequelae was the length of intensive care unit stay.
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