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Prevalence and Risk Factors for Cerebral Palsy in Children With Congenital Heart Disease Based on Risk of Surgical

Suman Ghosh1, Ing Grace Lien2, Kerstin Martinez3

  • 1State University of New York at Downstate Health Sciences University, Brooklyn, New York; Department of Neurology, New York City Health and Hospitals Corporation Kings County Hospital, Brooklyn, New York.

Pediatric Neurology
|April 19, 2024
PubMed

Insights

Congenital heart disease (CHD) in children is linked to a 7.7% rate of cerebral palsy (CP), much higher than the general population. Higher surgical risk categories, brain injury, and seizures increase CP risk in these children.

Area of Science:

  • Pediatric Cardiology
  • Neurology
  • Developmental Pediatrics

Background:

  • Children with congenital heart disease (CHD) often experience motor impairments, including cerebral palsy (CP), due to brain injury.
  • Understanding the prevalence and risk factors for CP in CHD is crucial for early intervention and improved outcomes.

Purpose of the Study:

  • To determine the prevalence of cerebral palsy (CP) in a pediatric cohort with congenital heart disease (CHD).
  • To stratify CP risk based on surgical mortality using Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) categories.
  • To identify specific risk factors associated with developing CP in children with CHD.

Main Methods:

  • A retrospective cohort study was conducted using data from the University of Florida (UF) Society of Thoracic Surgeons Congenital Heart Surgery database (2006-2017).
  • Included were pediatric patients diagnosed with CHD who received follow-up care at UF for over two years.
  • Data analysis focused on comparing children with and without CP regarding surgical factors, intensive care, and developmental outcomes.

Main Results:

  • Out of 701 children with CHD, 54 (7.7%) were diagnosed with CP, most commonly spastic hemiplegic CP (GMFCS Level 2).
  • Children with CHD and CP showed longer time from admission to surgery, higher STAT categories (4-5), and increased frequency of brain injury and seizures.
  • Significantly greater developmental disabilities and rehabilitation needs were observed in children with CHD and CP compared to those with CHD alone.

Conclusions:

  • The prevalence of CP in children with CHD was 7.7%, substantially higher than the 0.3% estimated for the general US population in 2010.
  • Higher STAT categories, presence of brain injury, and seizures are identified as significant risk factors for developing CP in children with CHD.
Abstract

Keywords:
Brain injuryCardiac surgeryDisabilitiesMotor impairmentNeurodevelopmentNeurodevelopmental disabilitiesSTAT

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