Neurodevelopment at 1 year of age in infants with congenital heart disease.
OBJECTIVE
To assess psychomotor development and neurological sequelae in infants after surgery for congenital heart defects.


METHODS
Single institution prospective cohort study.


METHODS
90 of 112 consecutive surviving infants of less than 1 year of age, without brain anomalies, conditions, or syndromes associated with delayed mental development, who underwent cardiac surgery during an 18 month period; 20 control infants with minor or no congenital heart defects.


METHODS
Griffiths developmental scales and standardised neurological examination at 1 year.


RESULTS
Mean (SD) developmental quotient (DQ) in index infants was 99 (10.6), compared with 106.7 (6.6) in controls (p < 0.001). DQ was lower in infants after palliative surgery (n = 16; 88 (12.2)) than after corrective surgery (n = 74; 101.4 (8.6)) (p < 0.001). Of the 90 index infants, 24 (27%) had a DQ below 93.5 (more than 2 SD below the mean of controls). Developmental delay (DQ < 93.5) was more common after palliative surgery (10/16, 63%) than after corrective surgery (14/74, 19%) (p < 0.001). Of the 90 index infants, 29 (32%) had neurological abnormalities, compared with only one of the 20 controls (5%) (p = 0.013). Neurological abnormalities were more frequent after palliative surgery (11/16, 69%) than after corrective surgery (18/74, 24%) (p < 0.001).


CONCLUSIONS
There is a considerable rate of neurodevelopmental impairment at 1 year of age in infants after cardiac surgery. Psychomotor impairment and neurological sequelae are apparently more severe in infants in whom only palliative surgery is possible.
Dittrich
H
H
Department of Congenital Heart Defects, German Heart Institute, Berlin, Germany.
Bührer
C
C
Grimmer
I
I
Dittrich
S
S
Abdul-Khaliq
H
H
Lange
P E
PE
D015331:Cohort Studies; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009460:Neurologic Examination; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000209:etiology*