Neurodevelopmental outcomes at 2 and 4 years in children with congenital heart disease

Congenit Heart Dis. 2018 Sep;13(5):700-705. doi: 10.1111/chd.12632. Epub 2018 Sep 6.

Abstract

Background and objectives: Children with congenital heart disease (CHD) are at risk for neurodevelopmental (ND) delays. The purpose of this study is to compare the ND testing results of children with CHD at 2 and 4 years of age and determine if rates of ND delays change over time.

Methods: Children with CHD completed the Bayley Scales of Infant Development-III (BSID-III) at 2 years of age, and standardized neuropsychological measures at 4 years. Scores were compared with test norms and were classified as: average (within one SD of test mean); at risk (1-2 SDs from the test mean); and delayed (>2 SD from test mean). Pearson correlations and McNemar's exact tests were performed to determine the relationship between test scores at the two times of assessment.

Results: Sixty-four patients completed evaluations at 24 ± 3 months of age and 4 years of age. BSID-III cognitive and fine motor scores were correlated with preschool IQ and fine motor scores, r = .75 to .87, P < .0001. Agreement in score categories was 79% for cognitive and 61% for fine motor. More patients had at risk or delayed scores at age 4 vs age 2 (P ≤ .01).

Conclusion(s): Despite significant correlations between 2- and 4-year-old test scores, many patients who scored in the average range at age 2 showed deficits at age 4. BSID-III scores at age 2 may underestimate delays. Therefore, longitudinal ND assessment is recommended.

Keywords: congenital heart disease/defects; developmental follow-up; developmental outcomes.

MeSH terms

  • Child
  • Child Development*
  • Child, Preschool
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / epidemiology
  • Developmental Disabilities / etiology*
  • Female
  • Heart Defects, Congenital / complications*
  • Humans
  • Incidence
  • Infant
  • Male
  • Neuropsychological Tests
  • Retrospective Studies
  • Wisconsin / epidemiology