Predicting neurodevelopmental delay in young children with heart disease

Investigators may have uncovered the factors predictive of adverse early neurodevelopmental outcomes in children with congenital heart disease.

In a cross-sectional study published in JAMA Network Open, the investigators used data from the Cardiac Neurodevelopmental Outcome Collaborative registry to assess the social and clinical variables potentially associated with the risk of early neurodevelopmental impairment in more than 850 pediatric patients under 2.5 years with congenital heart disease, who underwent cardiac surgical repair or palliation requiring cardiopulmonary bypass at younger than 1 year.

The investigators found that age, sex, birth weight, primary caregiver education, genetic and cardiac diagnoses, age at repair, length of stay, number of catheterizations and Child Opportunity Index were all predictive of adverse early neurodevelopmental outcomes. For instance, cardiac diagnoses were linked to cognitive and motor indexes. The highest scores were seen among those with great artery dextrotransposition. In addition, the investigators identified groups of participants who demonstrated poorer performance across the indexes involved in the study — including those who were in a lower birth weight category, male or older at their initial surgery; those who had longer hospital stays or a greater number of cardiac catheterizations; and those whose caregivers had a lower level of educational attainment.

Because earlier age at repair was found to be neuroprotective, the investigators noted that further studies are needed to determine the most effective preventive strategies options in this patient population. They concluded that all patients undergoing cardiac surgery at younger than 1 year should be monitored for neurodevelopmental outcomes.

Read more: JAMA Network Open

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