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Right arrow Congenital - cyanotic

J Thorac Cardiovasc Surg 2005;130:1511-1516
© 2005 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Effect of congenital heart disease on neurodevelopmental outcomes within multiple-gestation births

Amy H. Schultz, MD a , * , Gail P. Jarvik, MD, PhD h , Gil Wernovsky, MD a , Judy Bernbaum, MD b , Robert R. Clancy, MD c , Jo Ann D'Agostino, CRNP b , Marsha Gerdes, PhD d , Donna McDonald-McGinn, MS, CGC e , Susan C. Nicolson, MD g , Thomas L. Spray, MD f , Elaine Zackai, MD e , J. William Gaynor, MD f

a Divisions of Cardiology, General Pediatrics
b Neurology
c Psychology
d Genetics
e Cardiothoracic Surgery
f Department of Anesthesia and Critical Care Medicine
g The Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, Pa, and the Division of Medical Genetics
h Department of Medicine, University of Washington, Seattle, Wash

Received for publication May 16, 2005; revisions received June 29, 2005; accepted for publication July 12, 2005.

* Address for reprints: Amy H. Schultz, MD, Division of Cardiology, Children's Hospital and Regional Medical Center, 4800 Sand Point Way, W-4841, Seattle, WA 98105 (Email: ahschultz{at}uwalumni.com).

OBJECTIVES: We sought to assess the effect of congenital heart disease requiring surgical intervention with cardiopulmonary bypass at 6 months of age or less on developmental outcomes and growth at 1 year of age while controlling for socioeconomic status, prematurity, home environment, and parental intelligence.

METHODS: We performed within-family comparison of 11 multiple-gestation births in which one child had congenital heart disease. At 1 year of age, the Bayley Scales of Infant Development II were administered, and growth parameters were assessed. Paired comparisons were made by using fixed effects regression conditioned on family.

RESULTS: The multiple-gestation subjects were mildly premature on average (mean gestational age, 35.4 ± 3.0 weeks). At 1 year of age, children with congenital heart disease scored lower on the Mental Development Index (85.0 ± 19.3 vs 93.9 ± 16.0, P = .037) and the Psychomotor Development Index (76.6 ± 16.9 vs 91.3 ± 14.9, P = .015) on the Bayley Scales of Infant Development II than did their siblings without congenital heart disease. There were no differences between siblings in weight, height, or head circumference.

CONCLUSIONS: The presence of congenital heart disease requiring surgical intervention with cardiopulmonary bypass at 6 months of age or less is associated with a deficit in developmental achievement at 1 year of age, as measured by using the Bayley Scales of Infant Development II.

Abbreviations and Acronyms CHD = congenital heart disease; CPB = cardiopulmonary bypass; DHCA = deep hypothermic circulatory arrest; HLHS = hypoplastic left heart syndrome; MDI = Mental Development Index; PDI = Psychomotor Development Index; SES = socioeconomic status




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J. Thorac. Cardiovasc. Surg., February 1, 2008; 135(2): 240 - 242.
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