Neurodevelopmental outcomes at 2 and 4 years in children with congenital heart disease

Brosig, Cheryl L.; Bear, Laurel; Allen, Sydney; Simpson, Pippa; Zhang, Liyun; Frommelt, Michele A.; Mussatto, Kathleen A.

doi:10.1111/chd.12632

Cited by 33 publications

(22 citation statements)

References 24 publications

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“…In a study of CHD children, there was an overall good correlation between scores on the Bayley scale at age 2 and neurodevelopmental performance at age 4. However, several children who scored in the average range of the Bayley scales at age 2, had developed neurodevelopmental deficits by age 4 [ 167 ]. Abnormal cerebral findings in the prenatal and preoperative period may be better predictors of neurodevelopmental deficits.…”

Section: Discussionmentioning

confidence: 99%

Antenatal and Perioperative Mechanisms of Global Neurological Injury in Congenital Heart Disease

et al. 2020

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Congenital heart defects (CHD) is one of the most common types of birth defects. Thanks to advances in surgical techniques and intensive care, the majority of children with severe forms of CHD survive into adulthood. However, this increase in survival comes with a cost. CHD survivors have neurological functioning at the bottom of the normal range. A large spectrum of central nervous system dysmaturation leads to the deficits seen in critical CHD. The heart develops early during gestation, and CHD has a profound effect on fetal brain development for the remainder of gestation. Term infants with critical CHD are born with an immature brain, which is highly susceptible to hypoxic-ischemic injuries. Perioperative blood flow disturbances due to the CHD and the use of cardiopulmonary bypass or circulatory arrest during surgery cause additional neurological injuries. Innate patient factors, such as genetic syndromes and preterm birth, and postoperative complications play a larger role in neurological injury than perioperative factors. Strategies to reduce the disability burden in critical CHD survivors are urgently needed.

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Section: Discussionmentioning

confidence: 99%

Antenatal and Perioperative Mechanisms of Global Neurological Injury in Congenital Heart Disease

et al. 2020

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“…Common concerns for young children with congenital heart disease referred to cardiac neurodevelopmental programs include delays in gross motor skills, expressive language, behaviour dysregulation, and feeding difficulties. 8,12,33,39 Young children also present to cardiac neurodevelopmental programs with dysregulated sleep patterns and with separation or medical anxiety. 24,33,39,45,48,76,77 Once children reach preschool, grade retention is often considered by parents, sometimes at the recommendation of schools or providers.…”

Section: Referral Patternsmentioning

confidence: 99%

“…8,12,33,39 Young children also present to cardiac neurodevelopmental programs with dysregulated sleep patterns and with separation or medical anxiety. 24,33,39,45,48,76,77 Once children reach preschool, grade retention is often considered by parents, sometimes at the recommendation of schools or providers. Grade retention recommendations are most common among children with histories of repeat or prolonged hospitalisations, and who have reduced stamina and endurance.…”

Section: Referral Patternsmentioning

confidence: 99%

“…102 Clinical experience with the congenital heart disease population suggests certain similarities in the developmental patterns of children born preterm and those with congenital heart disease, such as disruption of regulatory functions, gross motor delays, and risk of cognitive challenges. 8,33,39,[103][104][105] Thus, the basis of this battery was informed by lessons from the prematurity literature, including a decision not to combine test scores from infancy with those gathered at age 18 months and later in describing the overall performance of children with congenital heart disease.…”

Section: Addressing Infant Assessment Controversiesmentioning

confidence: 99%

“…Infants and toddlers often have delayed motor, 1,15,[28][29][30] language, 1,[31][32][33][34] and cognitive 1,12,13,29,33,35 milestones. In preschool and early elementary years, other challenges become more prominent, including learning delays or disability, 30,33,[36][37][38][39] fine and graphomotor output challenges, 1,8,[40][41][42] poor attention, 29,36,39,43 and impaired social functioning. 1,33,34,39,44 Young children with congenital heart disease are at high risk for behaviour and mood problems, 16,45,46 and may appear less socially and emotionally mature than typically developing peers.…”

Section: Introductionmentioning

confidence: 99%

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Neurodevelopmental evaluation strategies for children with congenital heart disease aged birth through 5 years: recommendations from the cardiac neurodevelopmental outcome collaborative

et al. 2020

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This paper provides specific guidelines for the neurodevelopmental evaluation of children aged birth through 5 years with complex congenital heart disease. There is wide recognition that children with congenital heart disease are at high risk for neurodevelopmental impairments that are first apparent in infancy and often persist as children mature. Impairments among children with complex congenital heart disease cross developmental domains and affect multiple functional abilities. The guidelines provided are derived from the substantial body of research generated over the past 30 years describing the characteristic developmental profiles and the long-term trajectories of children surviving with complex congenital heart conditions. The content and the timing of the guidelines are consistent with the 2012 American Heart Association and the American Academy of Pediatrics scientific statement documenting the need for ongoing developmental monitoring and assessment from infancy through adolescence. The specific guidelines offered in this article were developed by a multidisciplinary clinical research team affiliated with the Cardiac Neurodevelopmental Outcome Collaborative, a not-for-profit organisation established to determine and implement best neurodevelopmental practices for children with congenital heart disease. The guidelines are designed for use in clinical and research applications and offer an abbreviated core protocol and an extended version that expands the scope of the evaluation. The guidelines emphasise the value of early risk identification, use of evidence-based assessment instruments, consideration of family and cultural preferences, and the importance of providing multidimensional community-based services to remediate risk.

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The Relationship Between Placental Pathology and Neurodevelopmental Outcomes in Complex Congenital Heart Disease

Segar¹,

Zhang²,

Ke³

et al. 2022

Pediatr Cardiol

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Neurodevelopmental outcomes at 2 and 4 years in children with congenital heart disease

Abstract: Despite significant correlations between 2- and 4-year-old test scores, many patients who scored in the average range at age 2 showed deficits at age 4. BSID-III scores at age 2 may underestimate delays. Therefore, longitudinal ND assessment is recommended.

Cited by 33 publications

References 24 publications

Antenatal and Perioperative Mechanisms of Global Neurological Injury in Congenital Heart Disease

Antenatal and Perioperative Mechanisms of Global Neurological Injury in Congenital Heart Disease

Neurodevelopmental evaluation strategies for children with congenital heart disease aged birth through 5 years: recommendations from the cardiac neurodevelopmental outcome collaborative

The Relationship Between Placental Pathology and Neurodevelopmental Outcomes in Complex Congenital Heart Disease

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