Neurodevelopmental status of newborns and infants with congenital heart defects before and after open heart surgery
Abstract
Background Neurodevelopmental disabilities in children with congenital heart defects (CHDs) have been primarily attributed to intraoperative events without consideration of preoperative and postoperative factors.Objective To describe the preoperative and postoperative neurodevelopmental status of newborns and infants with CHDs.Study design One hundred thirty-one children (56 newborns and 75 infants) were evaluated before and after surgery by using standardized neurobehavioral (newborn) and motor assessments (infant) and neurologic examinations.Results In newborns, neurobehavioral abnormalities were documented in >50% before surgery, with abnormalities persisting in most after surgery. In infants, neurodevelopmental abnormalities were observed in 38% before surgery. There was a significant association between preoperative and postoperative neurodevelopmental status, with status remaining unchanged in most. Newborns with acyanotic heart lesions were more likely to demonstrate neurologic compromise than those with cyanotic defects. For infants, arterial oxygen saturations <85% were significantly associated with an abnormality. There was a trend for a longer circulatory arrest time to be associated with greater risk for neurologic sequelae in newborns, whereas prolonged cardiopulmonary bypass was an important risk factor for infants.Conclusions Neurodevelopmental abnormalities are common in young infants with CHDs and are often present before open heart surgery. These developmental concerns are clinically underappreciated. Early systematic developmental screening may be warranted in this population of interest.
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A high prevalence of anatomic and functional neurologic abnormalities has been documented before surgery in newborns with congenital heart disease, and such abnormalities are associated with childhood developmental status.
“Reports from a number of investigators have documented a high prevalence of anatomic and functional neurologic abnormalities prior to surgery in newborns with CHD [9-17], and an association of such abnormalities with childhood developmental status [11,13,18,19].”
From Brain Volume and Metabolism in Fetuses With Congenital Heart Disease: Evaluation With Quantitative Magnetic Resonance Imaging and Spectroscopy (2010) · cites this paper as [10]
Adverse neurodevelopmental outcomes in children with complex congenital heart disease are due not only to perioperative insult but also to inborn factors.
“However, there is increasing evidence that adverse neurodevelopmental outcomes in children with complex CHD are due not only perioperative insult, but to inborn factors as well.”
From Brain Volume and Metabolism in Fetuses With Congenital Heart Disease: Evaluation With Quantitative Magnetic Resonance Imaging and Spectroscopy (2010) · cites this paper as [10]
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- Authors
- Limperopoulos, C., Majnemer, A., Shevell, M. I., Rosenblatt, B., Rohlicek, C., & Tchervenkov, C.
- Affiliations
- Montreal Children's Hospital (CA)
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2000-11
- Volume
- 137
- Issue
- 5
- Pages
- 638-645
- ISSN
- 0022-3476 (ISSN-L)
- OpenAlex
- W2008752887
- Cited by
- 274
- References
- 40
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 12 · 2023: 9 · 2022: 22 · 2021: 12 · 2020: 13 · 2019: 16 · 2018: 6 · 2017: 9 · 2016: 13 · 2015: 11 · 2014: 6 · 2013: 11 · 2012: 13
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Keywords
- congenital heart disease, neurodevelopmental disorders, open heart surgery, neonates, infants, neurobehavioral abnormalities, motor development, cyanotic congenital heart disease, arterial oxygen saturation, circulatory arrest time, cardiopulmonary bypass, developmental screening
- MeSH terms
- Child Development, Developmental Disabilities, Heart Defects, Congenital, Cardiac Surgical Procedures, Humans, Infant, Infant, Newborn, Nervous System Diseases, Neurologic Examination, Prospective Studies, Psychomotor Performance, Treatment Outcome
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