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Population-based study of cognitive outcomes in congenital heart defects

Johanna Calderon1,2, Marion Willaime1, Nathalie Lelong1

  • 1Department of Psychiatry, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA.

Archives of Disease in Childhood
|August 7, 2017
PubMed

Insights

Children with congenital heart defects (CHD) may face cognitive risks, even after surgery. Being small for gestational age is a key predictor of neurodevelopmental outcomes in these children.

Area of Science:

  • Pediatric Cardiology
  • Neurodevelopmental Pediatrics
  • Congenital Heart Disease Research

Background:

  • Congenital heart defects (CHD) affect a significant number of children.
  • Cognitive outcomes in children with CHD are a growing concern.
  • The impact of surgical vs. non-surgical interventions on cognitive development requires further characterization.

Purpose of the Study:

  • To compare cognitive outcomes in 3-year-old children with operated and non-operated congenital heart defects (CHD).
  • To identify risk factors associated with cognitive impairment in children with CHD.
  • To assess the neurodevelopmental prognosis in relation to interventions and perinatal factors.

Main Methods:

  • Prospective, population-based study of 419 children aged 3 years with CHD.
  • Cognitive function assessed using the Kaufman Assessment Battery for Children II.
  • Analysis of demographic, perinatal, and operative variables as predictors of cognitive outcomes.

Main Results:

  • Global cognitive scores did not differ between operated and non-operated groups.
  • Children undergoing open-heart surgery showed lower scores in expressive language and logical reasoning.
  • A higher proportion of children in the surgical group had global cognitive scores >1 SD below the mean.
  • Being small for gestational age (SGA) was a significant predictor of cognitive impairment in the surgical group (aOR=5.9).

Conclusions:

  • Preschool children with CHD, regardless of surgical intervention, are at risk for early cognitive challenges.
  • Small for gestational age (SGA) is a strong predictor of neurodevelopmental prognosis in children with CHD.
  • Early identification and intervention for cognitive risks in CHD are crucial.
Abstract

Keywords:
cognitive outcomescongenital heart diseaseminor CHDopen-heart surgerysmall for gestational age

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