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Factors affecting motor development of toddlers who received cardiac corrective procedures during infancy
Chia-Hui Chien1, Tzu-Ying Lee2, Ming-Tai Lin3
1Department of Nursing, National Taiwan University Hospital, No. 7, Chung-Shan S. Rd, Taipei 10002, Taiwan, ROC.
Insights
Toddlers with congenital heart disease (CHD) often experience developmental delays, even in low-risk categories. Early assessment of growth and motor skills is crucial for intervention after surgery.
Area of Science:
- Pediatric Cardiology
- Developmental Pediatrics
- Child Health
Background:
- Congenital heart surgery (CHD) risk adjustment (RACHS-1) is used for quality assessment.
- Children in RACHS-1 categories 1-4 have high survival but limited known developmental outcomes.
- Prognosis of motor development in toddlers with CHD is not well understood.
Purpose of the Study:
- Compare characteristics and motor development between toddlers with CHD and healthy controls.
- Examine factors influencing motor development in toddlers with CHD.
Main Methods:
- A comparative study design.
- Involved 48 toddlers with CHD and 39 healthy toddlers.
- Utilized Peabody Developmental Motor Scales (PDMS-2), anxiety, and vulnerability scales.
Main Results:
- Toddlers with CHD showed lower birth weight, height, weight-for-age, and more motor delays, but mothers had lower anxiety.
- Shorter hospitalization and higher weight-for-age z-scores predicted better gross motor development.
- Higher weight-for-age z-scores and low RACHS-1 categories predicted better total motor development.
Conclusions:
- Many children in RACHS-1 categories 1-4 exhibit below-average growth and motor development.
- Early assessment and intervention for growth and developmental progress are recommended post-surgery.
Background:
A risk adjustment in congenital heart surgery (RACHS-1) method was used for assessing quality of care in children undergoing congenital heart surgery. Children in RACHS-1 categories 1-4 had high survival rates. Little was known about these children and their prognosis of motor development during toddlerhood.
Aims:
To compare the differences between congenital heart disease (CHD) and healthy toddlers in terms of their characteristics, parental characteristics, parenting attitudes, and motor development, and further examine the influence of these factors on the motor development of the toddler with CHD.
Study Design:
A comparison study.
Subjects:
There were 48 toddlers in the CHD group and 39 in the healthy toddler group.
Outcomes Measures:
Current height and weight, Peabody Developmental Motor Scales second edition (PDMS-2), state-trait anxiety inventory (STAI) and Child Vulnerability Scale (CVS).
Results:
Compared to the healthy group, toddlers with CHD had lower birth weight, smaller height-for-age, lower weight-for-age, and more motor developmental delay, but their mothers had lower anxiety. A shorter length of hospitalization and higher weight-for-age z score predicted a better gross motor development, with 40.2% of the variance explained. A higher weight-for-age z score and low RACHS-1 categories predicted better total motor development, with 38.4% of the variance explained. Only low RACHS-1 categories predicted better fine-motor development, with 12% of the variance explained.
Conclusions:
Many children in RACHS-1 categories 1-4 had growth and motor development below average in their toddlerhood. Therefore, growth and developmental progress should be assessed and mediated early after corrective procedures.
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