Effect of congenital heart disease on neurodevelopmental outcomes within multiple-gestation births

Objectives

We sought to assess the effect of congenital heart disease requiring surgical intervention with cardiopulmonary bypass at 6 months of age or less on developmental outcomes and growth at 1 year of age while controlling for socioeconomic status, prematurity, home environment, and parental intelligence.

Methods

We performed within-family comparison of 11 multiple-gestation births in which one child had congenital heart disease. At 1 year of age, the Bayley Scales of Infant Development II were administered, and growth parameters were assessed. Paired comparisons were made by using fixed effects regression conditioned on family.

Results

The multiple-gestation subjects were mildly premature on average (mean gestational age, 35.4 ± 3.0 weeks). At 1 year of age, children with congenital heart disease scored lower on the Mental Development Index (85.0 ± 19.3 vs 93.9 ± 16.0, P = .037) and the Psychomotor Development Index (76.6 ± 16.9 vs 91.3 ± 14.9, P = .015) on the Bayley Scales of Infant Development II than did their siblings without congenital heart disease. There were no differences between siblings in weight, height, or head circumference.

Conclusions

The presence of congenital heart disease requiring surgical intervention with cardiopulmonary bypass at 6 months of age or less is associated with a deficit in developmental achievement at 1 year of age, as measured by using the Bayley Scales of Infant Development II.

Abbreviations and Acronyms:  CHD, congenital heart disease, CPB, cardiopulmonary bypass, DHCA, deep hypothermic circulatory arrest, HLHS, hypoplastic left heart syndrome, MDI, Mental Development Index, PDI, Psychomotor Development Index, SES, socioeconomic status

CTSNet classification:  21