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Does Congenital Heart Disease Affect Neurodevelopmental Outcomes in Children with Down Syndrome?

Tarek Alsaied1, Bradley S Marino2, Anna J Esbensen3

  • 1The Heart Institute at Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Congenital Heart Disease
|February 26, 2016
PubMed

Insights

Congenital heart disease (CHD) surgery in infancy impacts early language and development in children with Down syndrome (DS). However, these differences in neurodevelopmental outcomes resolve by school age.

Area of Science:

  • Pediatric Cardiology
  • Developmental Pediatrics
  • Genetics

Background:

  • Congenital heart disease (CHD) is common in children with Down syndrome (DS).
  • The impact of early cardiac surgery on neurodevelopmental outcomes in DS is not well understood.
  • Understanding these effects is crucial for developing targeted early interventions.

Purpose of the Study:

  • To assess the relationship between CHD requiring surgery in the first year of life and neurodevelopmental, behavioral, and emotional functioning in children with DS.
  • To compare outcomes between children with DS who had early cardiac surgery and those without CHD.

Main Methods:

  • Retrospective chart review of 1092 children (0-18 years) with DS.
  • Analysis included 178 children who underwent neurodevelopmental or academic testing.
  • Children were grouped into infants/toddlers (0-2), preschoolers (3-5), and school-age (6-18).
  • Statistical comparisons (t-test, chi-square, Mann Whitney U) were used.

Main Results:

  • Infants/toddlers with cardiac surgery showed significantly lower receptive, expressive, and composite language scores.
  • Preschoolers with cardiac surgery had lower language and visual motor scores, though not statistically significant.
  • No significant differences in IQ, language, academic achievement, ADHD, executive function, or behavioral scores were found at school age.

Conclusions:

  • Early cardiac surgery in children with DS is associated with poorer early neurodevelopmental outcomes, particularly in language.
  • These neurodevelopmental deficits appear to resolve by school age.
  • Findings can inform early intervention strategies and family counseling post-CHD repair.
Abstract

Keywords:
Cardiac SurgeryComplete Atrioventricular Septal DefectCongenital Heart DiseaseDevelopmental DelayDown SyndromeNeurodevelopmental Outcomes

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