Short-term neurodevelopmental outcomes in neonates with congenital heart disease: the era of newer surgical strategies.
OBJECTIVE
The objective of this study was to determine neurodevelopmental outcomes up to 30 months of age in a cohort of neonates requiring surgical intervention without circulatory arrest for congenital heart disease and to correlate these outcomes with characteristics detected prior to hospital discharge.


METHODS
An observational cohort of surviving neonates who underwent surgical intervention without circulatory arrest for congenital heart disease between 2002 and 2003 was studied at a single tertiary care institution.


METHODS
Thirty-five patients were followed from 4 to 6 months of age until 24-30 months of age.


METHODS
Neuromotor abnormalities, use of special services, and degree of developmental delay at set intervals between 4 and 30 months of age were retrospectively obtained from clinical reports. The relationship between these outcomes and clinical characteristics prior to hospital discharge was analyzed.


RESULTS
Those with neuromotor abnormalities prior to discharge were likely to have persistent abnormalities in muscle strength, tone, and symmetry until 4-6 months of age, odds ratio 6 (1.3-29). By 24-30 months of age, motor abnormalities or developmental delay occurred in 10 of 20 infants (50%), but were no longer significantly associated with predischarge findings.


CONCLUSIONS
Infants undergoing surgical intervention for congenital heart disease are at risk for neurodevelopmental abnormalities, which may not become apparent until months after hospital discharge. Early impairment may also resolve over time. Close developmental follow-up in this high-risk cohort of patients is warranted.
Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, Calif, USA. vchock@stanford.edu
Valerie Y
VY
Chock
Irene J
IJ
Chang
V Mohan
VM
Reddy
D000367:Age Factors; D002140:California; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002657:Child Development; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation; D061345:Early Medical Intervention / Q000706:statistics & numerical data; D005260:Female; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009048:Motor Skills; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000254:growth & development; D009420:Nervous System / Q000254:growth & development*; D009788:Occupational Therapy / Q000706:statistics & numerical data; D016017:Odds Ratio; D010351:Patient Discharge; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013070:Speech Therapy; D016896:Treatment Outcome