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Screening and Evaluation of Neurodevelopmental Impairments in Infants Under 6 Months of Age with Congenital Heart Disease

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Abstract

Clinical evaluation of neurodevelopmental impairments before 6 months of age is needed in congenital heart disease (CHD) to promote early referral to developmental interventions. The objective was to identify the risk of cerebral palsy (CP) and to compare neurodevelopment outcomes in infants with and without CHD. In a longitudinal study, 30 infants with CHD and 15 infants without CHD were assessed at 1 month, 3 months, and 6 months of age. Included measures were General Movement Assessment (GMA), Test of Infant Motor Performance (TIMP) and the Bayley Scale of Infant Development, third edition (Bayley-III), selected to identify the risk of CP, document neurodevelopmental impairments and infants’ eligibility for early intervention services. Abnormal GMA categories were found in the CHD group where 48% had poor repertoire and 15% were at high risk of CP. At 3 months of age, CHD group had significantly lower TIMP scores compared to infants without CHD [t(41) = 6.57, p = 0.01]. All infants in the study had higher Bayley-III scores at 6 months than at 3 months of age. Infants with CHD had lower gross motor, fine motor and cognitive Bayley-III scores compared to their peers without CHD. Over time infants without CHD outperformed the CHD group in the gross motor skills [F(1,41) = 11.76, p = .001]. Higher prevalence of abnormal GMs, lower TIMP and Bayley-III were found in infants with single ventricle physiology compared to two-ventricle physiology. The risk of CP exists in infants with CHD, and these infants have worse outcomes compared to their peers without CHD. These differences are intensified in the single ventricle population.

Clinical Trial Registration National Institute of Health, Unique identifier: NCT03104751; Date of registration—April 7, 2017.

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Availability of Data and Materials

Data supporting the findings of this study are available from the senior, corresponding author upon reasonable request (jill.heathcock@osumc.edu).

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Acknowledgements

We would like to acknowledge the time and effort of parents and infants who participated in this study. The research staff of Pediatric and Rehabilitation Laboratory at OSU and Nationwide Children’s Hospital at Columbus, Ohio for assistance with data collection. We also would like to acknowledge the cardiac surgeons, cardiologists, and pediatric intensive care staff for their support to our study.

Funding

All phases of this study were supported by American Heart Association, GRNT27760156. The funding source had no role in study design, the collection, analysis, and interpretation of data, the writing of the report, or the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Pediatric and Rehabilitation Laboratory, School of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH, USA

    Tanya Tripathi, Thais Invencao Cabral & Jill C. Heathcock

  2. College of Nursing, Ohio State University, Columbus, OH, USA

    Tondi M. Harrison

  3. The Heart Center at Nationwide Children’s Hospital, Columbus, OH, USA

    Janet M. Simsic

  4. The Ohio State University, Columbus, OH, USA

    Janet M. Simsic

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  1. Tanya Tripathi
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Contributions

TT analyzed and interpreted the data, drafted the initial manuscript, and reviewed and revised the manuscript. JCH conceptualized and designed the study, obtained funding, drafted the initial manuscript, and reviewed and revised the manuscript. JMS and TMH conceptualized and designed the study, obtained funding, and reviewed and revised the manuscript. TIC collected and interpreted the data, and reviewed and revised the manuscript.

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Correspondence to Tanya Tripathi.

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The authors declare no conflict of interest.

Ethical Approval

The study was approved by the Nationwide Children’s Hospital’s Institutional Review Board. Written informed consent was obtained from parents of all infants who participated in the study.

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Tripathi, T., Harrison, T.M., Simsic, J.M. et al. Screening and Evaluation of Neurodevelopmental Impairments in Infants Under 6 Months of Age with Congenital Heart Disease. Pediatr Cardiol 43, 489–496 (2022). https://doi.org/10.1007/s00246-021-02745-4

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