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 .
Neurologic status of newborns with congenital heart defects before open heart surgery.
UNLABELLED Controversy exists regarding the integrity of the nervous system in the newborn with a congenital heart defect who must undergo corrective or palliative open heart surgery .  Neurodevelopmental sequelae have been primarily attributed to surgical procedures without st and ardized evaluation of the preoperative neurologic status . OBJECTIVE To determine whether newborns with congenital heart defects demonstrate abnormalities in neurobehavioral status before surgery . STUDY DESIGN In this prospect i ve study , a st and ardized neonatal neurobehavioral assessment and a neurologic examination  were conducted independently in a consecutive series of 56 neonates referred to our hospital for investigation of open heart surgery . RESULTS Neurobehavioral and neurologic abnormalities were documented in greater than half of the cohort and included hypotonia , hypertonia , jitteriness , motor asymmetries , and absent suck . Poor state regulation ( 62 % ) and feeding difficulties ( 34 % ) also were commonly observed . Furthermore , 3 subjects had seizures , 35.7 % were microcephalic , and 12.5 % were macrocephalic . The overall likelihood of neurobehavioral abnormalities was not enhanced by indicators of cardiorespiratory compromise . Interestingly , newborns with acyanotic congenital heart defects were more likely to demonstrate neurologic compromise than were those with cyanotic defects . CONCLUSIONS Findings suggest that the prevalence of neurobehavioral abnormalities before surgery in newborns with congenital heart defects has been underappreciated and would indicate that factors other than intraoperative procedures should be considered in the genesis of brain injury in this population .congenital heart defects , neurologic examination , newborn
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 .