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 .
Early childhood language outcomes after arterial switch operation: a prospective cohort study
Background Developmental and language outcomes at 2 years of age of children who had arterial switch operation ( ASO ) for transposition of the great arteries 2004–2010 are described . Methods In this prospect i ve cohort study , 91/98 ( 93 % ) children who underwent ASO  were assessed at 2 years of age with the Bayley Scales of Infant & Toddler Development—3rd Edition . Outcomes were compared by patient and perioperative variables using bivariate and multivariate regression analyses to identify predictors of language delay . Results Infants without ventricular septal defect ( VSD ) ( n = 60 ) were more likely to be outborn ( 73 vs 58 % , p = 0.038 ) , require septostomy ( 80 vs 58 % , p = 0.026 ) , have a shorter cross clamp time ( min ) ( 62.7 vs 73.0 , p = 0.019 ) , and a lower day 1 post-operative plasma lactate ( mmol/L ) ( 3.9 vs 4.8 , p = 0.010 ) . There were no differences in cognitive , motor and language outcomes based on presence of a VSD . Language delay ( < 85 ) of 29 % was 1.8 times higher than the normative sample ; risk factors for this in multivariate analyses included < 12 years of maternal education ( AOR 19.3 , 95 % CI 2.5–148.0 ) and cross-clamp time ≥70 min ( AOR 14.5 , 95 % CI 3.1–68.5 ) . Maternal education < 12 years was associated with lower Language Composite Scores ( −20.2 , 95 % CI −32.3 to −9.1 ) . Conclusions Outcomes at 2 years of age in children who undergo ASO are comparable to the normative sample with the exception of language . There is a risk of language delay for which maternal education and cross-clamp duration are predictors . These findings suggest that focused post-operative early language interventions could be considered
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 .