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Neurodevelopmental Assessment in Children With Congenital Heart Disease by Applying the Denver Developmental
Keta Vagha1, Amar Taksande1, Sneha Kenjale1
1Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Insights
Congenital heart disease (CHD) significantly impacts child development, particularly gross motor skills. Cyanotic CHD poses a higher risk for developmental delays compared to acyanotic CHD in children.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Pediatrics
- Developmental Psychology
Background:
- Congenital heart conditions (CHDs) are linked to lifelong neurodevelopmental challenges in children.
- Limited research exists on developmental status in children with CHDs in central India.
- Understanding the impact of heart defects on a child's developing brain is crucial.
Purpose of the Study:
- To evaluate neurodevelopmental conditions in children with CHD using the Denver Developmental Screening Test 2 (DDST-2).
- To compare neurodevelopmental outcomes between children with acyanotic CHD (ACHD) and cyanotic CHD (CCHD).
- To determine the prevalence of developmental delay in children diagnosed with CHD.
Main Methods:
- A cross-sectional study involving 82 children aged six months to six years with confirmed CHD.
- Neurodevelopmental assessment conducted using the DDST-2, evaluating personal-social, fine motor-adaptive, language, and gross motor domains.
- Exclusion criteria included critical illness, genetic syndromes, and unwillingness to participate.
Main Results:
- The highest prevalence of developmental delay in children with CHD was observed in the gross motor domain, with the social domain being least affected.
- Comparative analysis revealed a significant difference in developmental delay between ACHD and CCHD primarily in the gross motor domain.
- Developmental quotient (DQ) analysis corroborated the DDST-2 findings regarding domain-specific delays.
Conclusions:
- The DDST-2 is an effective screening tool for assessing neurodevelopment in infants with CHD.
- Gross motor skills are most frequently impacted in both ACHD and CCHD, followed by fine motor skills.
- Children with cyanotic CHD exhibit a greater susceptibility to developmental delays than those with acyanotic CHD.
Abstract:
Background Congenital heart conditions often cause developmental delays and impact neurodevelopment throughout one's lifetime. Hence, it is crucial to analyze the impact that heart defects have on the developing brain of a child. The present cross-sectional study was undertaken given the paucity of studies on the developmental status in children with congenital heart diseases (CHDs) in central India, where we tried to evaluate and compare the prevalence of neurodevelopmental delay in individuals with different congenital cardiac disorders. The objectives of our study were, firstly, to utilize the Denver Developmental Screening Test 2 (DDST-2) to evaluate the neurodevelopmental conditions in children with CHD; secondly, to compare the neurodevelopmental state of children with acyanotic CHD (ACHD) and cyanotic CHD (CCHD); and thirdly, to ascertain the prevalence of developmental delay in children with CHD. Methodology The study population comprised children aged six months to six years with two-dimensional (2D) echocardiography confirmation of CHD; those who were critically ill, had genetic syndromes, and were not willing to participate in the study were excluded. The neurodevelopmental assessment was conducted using the DDST-2. The screening looked at each patient's progress in four areas: personal-social, fine motor-adaptive, language, and gross motor. Based on these observations, results were obtained and interpreted. Result Out of 82 children with CHD, the prevalence rate of developmental delay according to the DDST-2 was found to be maximum in the gross motor domain and the least affected in the social domain, which was similar to the analysis of developmental delay by developmental quotient (DQ). The comparative analysis of developmental delay in ACHD and CCHD according to the DDST-2 showed a significant P value only in the gross motor domain. Conclusion The DDST-2 is a straightforward screening tool for determining how well-developed infants with CHD are. The gross motor domain is the most frequently damaged in ACHD and CCHD, followed by the fine motor domain, and the social domain is the least affected. Cyanotic CHD patients are more susceptible to developmental delay than children with ACHD.
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