Severe Congenital Heart Defects and Cerebral Palsy

Ester Garne; Shona Goldsmith; Ingeborg Barisic; Paula Braz; Ivana Dakovic; Catherine Gibson; Michele Hansen; Christina E Hoei-Hansen; Sandra Julsen Hollung; Kari Klungsøyr; Hayley Smithers-Sheedy; Daniel Virella; Nadia Badawi; Linda Watson; Sarah McIntyre

doi:10.1016/j.jpeds.2023.113617

Severe Congenital Heart Defects and Cerebral Palsy

J Pediatr. 2023 Nov:262:113617. doi: 10.1016/j.jpeds.2023.113617. Epub 2023 Jul 18.

Authors

Affiliations

¹ Department of Pediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark. Electronic address: Ester.garne@rsyd.dk.
² Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia.
³ Children's Hospital Zagreb, Center of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia.
⁴ National Registry of Congenital Anomalies, Department of Epidemiology, National Health Institute Dr Richardo Jorge, Lisbon, Portugal.
⁵ Children's Hospital, Medical School, University of Zagreb, Zagreb, Croatia.
⁶ South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, South Australia, Australia.
⁷ Western Australian Register of Developmental Anomalies, Department of Health Western Australia, Perth, Australia; Telethon Kids Institute, the University of Western Australia, Perth, Australia.
⁸ Department of Pediatrics, University Hospital Rigshospitalet and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁹ Norwegian Quality and Surveillance Registry for Cerebral Palsy, Vestfold Hospital Trust, Tønsberg, Norway.
¹⁰ Department of Global Public Health and Primary Care, University of Bergen, Norway, and Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway.
¹¹ National Registry for Surveillance of Cerebral Palsy, Department of Epidemiology, National Health Institute Dr Richardo Jorge, Lisbon, Portugal.
¹² Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia; Grace Center for Newborn Intensive Care, Children's Hospital at Westmead, Sydney, Australia.
¹³ Western Australian Register of Developmental Anomalies, Department of Health Western Australia, Perth, Australia.

PMID: 37473991
DOI: 10.1016/j.jpeds.2023.113617

Abstract

Objective: To report the prevalence of cerebral palsy (CP) in children with severe congenital heart defects (sCHD) and the outcome/severity of the CP.

Methods: Population-based, data linkage study between CP and congenital anomaly registers in Europe and Australia. The EUROCAT definition of severe CHD (sCHD) was used. Linked data from 4 regions in Europe and 2 in Australia were included. All children born in the regions from 1991 through 2009 diagnosed with CP and/or sCHD were included. Linkage was completed locally. Deidentified linked data were pooled for analyses.

Results: The study sample included 4989 children with CP and 3684 children with sCHD. The total number of livebirths in the population was 1 734 612. The prevalence of CP was 2.9 per 1000 births (95% CI, 2.8-3.0) and the prevalence of sCHD was 2.1 per 1000 births (95% CI, 2.1-2.2). Of children with sCHD, 1.5% (n = 57) had a diagnosis of CP, of which 35 (61%) children had prenatally or perinatally acquired CP (resulting from a brain injury at ≤28 days of life) and 22 (39%) children had a postneonatal cause (a brain injury between 28 days and 2 years). Children with CP and sCHD more often had unilateral spastic CP and more intellectual impairments than children with CP without congenital anomalies.

Conclusions: In high-income countries, the proportion of children with CP is much higher in children with sCHD than in the background population. The severity of disease in children with CP and sCHD is milder compared with children with CP without congenital anomalies.

Keywords: CHD; brain injury; cerebral palsy; intellectual impairment; severity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain Injuries*
Cerebral Palsy* / diagnosis
Cerebral Palsy* / epidemiology
Child
Europe / epidemiology
Heart Defects, Congenital* / epidemiology
Humans
Prevalence
Registries