Early-Term Birth in Single-Ventricle Congenital Heart Disease After the Fontan Procedure: Neurodevelopmental and Psychiatric Outcomes
Abstract
Objectives To investigate the long-term impact of early-term birth (37-38 weeks' gestation) relative to full-term birth (≥39 weeks' gestation) on neurodevelopmental and psychiatric outcomes in adolescents with single-ventricle congenital heart disease (CHD).Study design This cross-sectional cohort study analyzed retrospective medical records from full term adolescents with single-ventricle CHD who underwent the Fontan procedure. Participants underwent neurodevelopmental and psychiatric evaluations, as well as structural brain magnetic resonance imaging. Early-term born adolescents were compared with full-term born adolescents using regression models with adjustments for family social status, birth weight, and genetic abnormality status. Medical and demographic risk factors were examined as well.Results Compared with the full-term group (n = 100), adolescents born early term (n = 33) scored significantly worse on daily-life executive functions, as measured by the Behavior Rating Inventory of Executive Function parent-report (mean scores: early term, 62.0 ± 10.9; full-term, 55.6 ± 12.2; P = .009) and self-report (P = .02) composites. Adolescents born early term were more likely than those born full term to have a lifetime attention-deficit/hyperactivity disorder (ADHD) diagnosis (early term, 55%; full term, 26%; P = .001). The early-term group also displayed greater psychiatric symptom severity, as indicated by the clinician-reported Brief Psychiatric Rating Scale (mean score: early term, 16.1 ± 8.6; full-term, 12.5 ± 8.2; P = .007).Conclusion Early-term birth is associated with greater prevalence of executive dysfunction, ADHD diagnosis, and psychiatric problems in adolescents with single-ventricle CHD. Early-term birth should be included as a potential risk factor in the algorithm for closer developmental surveillance in CHD.
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- Authors
- Calderon, J., Stopp, C., Wypij, D., DeMaso, D. R., Rivkin, M., Newburger, J. W., & Bellinger, D. C.
- Affiliations
- Boston Children's Hospital (US)
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 179
- Pages
- 96-103
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W2525273193
- Cited by
- 59
- References
- 46
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 5 · 2023: 9 · 2022: 11 · 2021: 5 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 4
- FWCI
- 4.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01 HL096825)
- Ford Family Foundation (R01 HL096825)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Keywords
- early term birth, single ventricle congenital heart disease, Fontan procedure, neurodevelopmental outcomes, mental health outcomes, executive dysfunction, attention deficit hyperactivity disorder, adolescents, child development monitoring, gestational age
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Cross-Sectional Studies, Female, Gestational Age, Heart Defects, Congenital, Heart Ventricles, Humans, Male, Cohort Studies, Fontan Procedure, Term Birth, Executive Function, Neurodevelopmental Disorders
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