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Longitudinal Motor-Developmental Outcomes in Infants with a Critical Congenital Heart Defect
Maaike C A Sprong1, Marco van Brussel1, Linda S de Vries2
1Center of Child Development, Exercise and Physical Literacy, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3508 AB Utrecht, The Netherlands.
Insights
Infants with critical congenital heart defects (CCHDs) show varied motor development pathways. While most achieve average scores, those with single-ventricle physiology exhibit persistent motor deficits, highlighting the need for early intervention.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Cardiology
Background:
- Critical congenital heart defects (CCHDs) are associated with increased risks of neurodevelopmental delays in infants.
- Early identification and intervention for motor delays are crucial to mitigate long-term adverse outcomes.
- Understanding motor development trajectories in infants with CCHDs is essential for clinical management.
Purpose of the Study:
- To describe the motor-developmental pathways of infants diagnosed with critical congenital heart defects.
- To identify specific motor deficits and their prevalence across different age points in this population.
- To compare motor skills between infants with single-ventricle physiology and those with other CCHDs.
Main Methods:
- Longitudinal assessment of motor development using the Dutch version of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).
- Data collected from 215 infants and toddlers at 3, 9, and 18 months of corrected age.
- Analysis of motor composite scores, prevalence of motor deficits (≤-2 SD), and comparison between subgroups.
Main Results:
- Overall motor composite scores showed improvement with age (97 at 3 months, 98 at 9 months, 104 at 18 months).
- Significant gross motor deficits (≤-2 SD) increased with age, observed in 2.4% at 3 months and 2.3% at 18 months.
- Infants with single-ventricle physiology demonstrated significantly poorer fine and gross motor skills at 9 and 18 months compared to other CCHD groups.
Conclusions:
- Most infants with CCHDs maintain average motor skills, but a subset experiences persistent delays, particularly in gross motor function.
- Abnormal gross motor scores tend to increase with age, suggesting a need for ongoing monitoring.
- Single-ventricle physiology is a significant risk factor for poorer motor outcomes in infants with CCHDs, necessitating targeted developmental support.
Abstract:
Infants with critical congenital heart defects (CCHDs) are at increased risk for neurodevelopmental delays. The early identification of motor delays is clinically relevant to prevent or reduce long-term consequences. The current study aims to describe the motor-developmental pathways of infants with a CCHD. Motor development was assessed in 215 infants and toddlers using the Dutch version of the Bayley-III. At 3 months (n = 165), 9 months (n = 188), and 18 months (n = 171) the motor composite scores were 97, 98, and 104, respectively. A motor composite score of ≤-2 SD was only seen in 2.4%, 0%, and 2.3%, respectively, with gross motor deficits being observed more often than fine motor deficits (12% vs. 0% at 18 months). Over 90% of infants who scored average at 9 months still did so at 18 months. The majority of infants with below-average gross motor scores (≤-1) at 9 months still had a below-average or delayed motor score (≤-2 SD) at 18 months. Abnormal gross motor scores (≤-2 SD) increased with age. Infants with single-ventricle physiology performed significantly (p ≤ 0.05) worse on both fine and gross motor skills at 9 and 18 months compared to infants with other CCHDs.
