Abstract 12569: Relationship Between Neurodevelopmental Outcomes at 2 Years and 4 Years in Children With Congenital Heart Disease After Surgical Palliation
Introduction: Children with congenital heart disease (CHD) are at risk for neurodevelopmental (ND) delays. The American Heart Association (AHA) recommends serial ND evaluation for children with CHD. This study compares the ND testing results of children with CHD at 2 and 4 years of age.
Methods: Children with CHD meeting the AHA high-risk criteria for ND delay were seen for longitudinal developmental evaluation. Testing included the Bayley Scales of Infant Development - III (BSID-III) at 2 years (±3 months) of age, and standardized neuropsychological measures at 4 years. Scores were compared to test norms and were classified as: average (within one SD of test mean); at risk (1-2 SDs from the test mean); and impaired (>2SD from test mean). Spearman correlations and McNemar’s exact tests were performed to determine the relationship between test scores at the two times of assessment.
Results: Of the 102 patients evaluated at 4 years of age, 73% (n=75) had a previous evaluation using the BSID-III; 48 (47%) completed the BSID-III at 24±3 months of age. Median age at first cardiac operation was 13 days. Patients had the following characteristics: single ventricle anatomy 33%; male 63%; prenatal diagnosis 53%; premature 18%; non-white/Hispanic race 13%; and comorbidities: medical 25%, genetic 17%. BSID-III cognitive, language, and motor scores were correlated with preschool IQ, language, and motor scores, r = 0.49 to 0.75, all p<0.01. Of the patients who had average or above BSID-III cognitive scores at age 2, 29.7% scored in the at risk or delayed range on the preschool IQ test.
Conclusion: BSID-III scores at 2 years are significantly associated with ND outcomes at 4 years. However, even though scores were related, many patients who scored in the average range at age 2 showed some deficits at age 4. Therefore, longitudinal ND assessment is recommended.
Author Disclosures: C.L. Brosig: None. L. Bear: None. S. Allen: None. R.G. Hoffmann: None. A. Pan: None. M. Frommelt: None. K.A. Mussatto: None.
- © 2016 by American Heart Association, Inc.