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 .
Prediction of IQ and Achievement at Age 8 Years From Neurodevelopmental Status at Age 1 Year in Children With D-Transposition of the Great Arteries
Objective . Studies of developmental outcomes in children with congenital heart disease ( CHD ) frequently use assessment s conducted in infancy as primary endpoints . Whether test scores of CHD patients in infancy are predictive of status at school age has not been evaluated , however . Methods . In the Boston Circulatory Arrest Study , 135 children with D-transposition of the great arteries repaired by arterial switch operation  were administered the  Bayley Scales of Infant Development  and the Fagan Test of Infant Intelligence  at 1 year of age and the Wechsler Intelligence Scale for Children , Third Edition and the Wechsler Individual Achievement Test at 8 years . Results . Although most 1-year test scores were significantly associated with 8-year test scores , the amounts of shared variance were modest ( < 10 % ) . All 1-year test scores had poor sensitivity ( 16%–32 % ) and poor positive predictive value ( 35%–42 % ) but good specificity ( 80%–93 % ) and negative predictive value ( 78%–79 % ) . More than half of the children with low scores at 8 years ( ≤85 ) had had scores > 84 at 1 year . Conclusion . This pattern suggests that although test scores at 1 year are modestly associated with test scores at 8 years , many children who are at risk for poor late outcomes will not be identified on the basis of 1-year test scores . Long-term follow-up of children with CHD is necessary to draw inferences about the developmental sequelae of preoperative , intraoperative , and postoperative factors
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 .