Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .
Effect of prenatal diagnosis on outcomes in D-transposition of the great arteries.
BACKGROUND By decreasing preoperative morbidity , prenatal diagnosis could improve neurodevelopmental outcomes in infants with critical congenital heart disease . We explored the impact of prenatal diagnosis on perinatal and perioperative variables and on outcomes at 1 year of age . METHODS We analyzed a data base of children enrolled in prospect i ve studies on surgical support techniques from 1988 to 2000 . Selection criteria included a diagnosis of D-transposition of the great arteries with intact ventricular septum or ventricular septal defect , no extracardiac congenital anomalies , birth weight > 2.3 kg , and repair by arterial switch procedure .  RESULTS Of 346 patients at enrollment , 25 had a prenatal diagnosis , and 321 did not . Children with prenatal diagnosis , compared with those without , had a lower likelihood of birth by spontaneous labor , lower birth weights , lower Apgar 5 scores , a higher rate of preoperative endotracheal intubation , and surgery at a younger age . They tended to have a lower incidence of fetal distress during labor . At 1 year of age , 272 patients were tested with the Psychomotor Development Index and Mental Development Index of the Bayley Scales . Mean z scores were similar in those with and without prenatal diagnosis for both Psychomotor Development Index ( -0.92 + /- 0.93 vs -0.88 + /- 1.05 ) and Mental Development Index ( -0.29 + /- 1.13 vs -0.41 + /- 0.93 ) . CONCLUSIONS Infants with D-transposition of the great arteries with and without prenatal diagnosis differed with respect to perinatal and perioperative variables , but their development at 1 year of age was similar . Future studies should include a greater number of children with prenatal diagnosis and a variety of congenital heart lesions
Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .