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 preschool functional abilities after early complex cardiac surgery.
BACKGROUND It is important to identify early predictors of functional limitations in children after congenital heart surgery to optimise their independence as they prepare for school . The purpose of this study is to determine potentially modifiable predictor variables of functional abilities in pre-school children who underwent complex cardiac surgery at 6 weeks of age or earlier . METHODS This prospect i ve inception cohort study comprised a sample of 165 survivors ( 63 % boys ) who had complex cardiac surgery ( 75 % biventricular repairs ) at Stollery Children 's Hospital , Edmonton , Alberta . We excluded children with chromosomal abnormalities . When children were 4 - 5 years of age , the parents completed the Adaptive Behavioral Assessment System II . Regression analysis was used to assess the association between multiple risk factors and each of the four continuous composite scores . RESULTS The mean scores for the practical domain and general adaptive composite score of the Adaptive Behavioural Assessment System were lower than the conceptual and social domains , with 13.3 % of the children having a delay in the practical domain . There was a significant association between the general adaptive ( p=0.003 ; 0.012 ) , conceptual ( p=0.0004 ; 0.042 ) , social ( p=0.0007 ; 0.028 ) , and the practical ( p=0.046 ; 0.003 ) domain composite scores with the mother 's education and preoperative plasma lactate , respectively . CONCLUSION Maternal education may be a marker for the social context of children , and warrants societal attention to improve functional outcomes . Preoperative lactate as a potentially modifiable variable may warrant increased attention to early diagnosis and aggressive resuscitation of young infants with congenital heart disease
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 .