Cohort and Individual Neurodevelopmental Stability between 1 and 6 Years of Age in Children with Congenital Heart Disease

Naef, Nadja; Wehrle, Flavia M.; Rousson, Valentin; Latal, Beatrice

doi:10.1016/j.jpeds.2019.08.036

Cited by 20 publications

(27 citation statements)

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“…Children were eligible for the current study if they had been assessed between July 2017 and mid‐March 2020 (i.e., prior to the implementation of lockdown measures in Switzerland) and their parents had completed a set of questionnaires on child well‐being and family functioning as part of the study ( n = 221). The second study, Research and Child Health Outcome (ReachOut), followed children with CHD who underwent first cardiopulmonary surgery between 2004 and 2009 at below 6 years of age 17 . Children were eligible if their parents had completed questionnaires on child well‐being and parental mental health during the 10‐year follow‐up between January 2013 and November 2019 ( n = 125).…”

Section: Methodsmentioning

confidence: 99%

“…The second study, Research and Child Health Outcome (ReachOut), followed children with CHD who underwent first cardiopulmonary surgery between 2004 and 2009 at below 6 years of age. 17 Children were eligible if their parents had completed questionnaires on child well-being and parental mental health during the 10-year follow-up between January 2013 and November 2019 (n = 125). Figure S1 details the recruitment procedure.…”

Section: Participants and Study Proceduresmentioning

confidence: 99%

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Impact of the COVID‐19 pandemic on children with and without risk for neurodevelopmental impairments

et al. 2021

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Aim To examine how the ongoing COVID‐19 pandemic impacts child well‐being and family functioning, particularly among children at risk for neurodevelopmental impairments. Methods Families of 73 typically developing children, 54 children born very preterm (VPT) and 73 children with congenital heart disease (CHD) from two prospective cohort studies were assessed prior to (mean age: 10.4 [SD: 1.2] years) and during (mean age: 12.8 [SD: 2.0] years) the pandemic, more specifically, in April/May 2020. Child well‐being and family functioning were assessed with validated, parent‐reported questionnaires and tested with linear mixed models. Group comparison of child distress and parental concerns related to medical implications of COVID‐19 and homeschooling, assessed with 5‐point Likert scales, was done with Mann–Whitney U tests. Results Children's psychological well‐being and family functioning (both, p < 0.001) decreased significantly during the pandemic, irrespective of group. Children with CHD were reported to be more concerned about becoming infected with SARS‐CoV‐2 than were others. Child distress due to homeschooling and parents' concerns about children's academic achievements were significantly higher in VPT and CHD children than in typically developing peers (all p < 0.001). Conclusion The COVID‐19 pandemic substantially impacts the whole family and leads to additional distress in families with children at risk for neurodevelopmental impairments. These families should receive individualised counselling and assistance from healthcare providers and schools during the pandemic.

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Section: Methodsmentioning

confidence: 99%

Section: Participants and Study Proceduresmentioning

confidence: 99%

Impact of the COVID‐19 pandemic on children with and without risk for neurodevelopmental impairments

et al. 2021

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“…Children with different types of CHD were recruited from the prospective cohort study Research and Child Health Outcome (REACHOUT) of the University Children's Hospital Zurich, Switzerland (19). All patients underwent CPB surgery between 2004 and 2009, at below 6 years of age.…”

Section: Study Populationmentioning

confidence: 99%

Social and Behavioral Difficulties in 10-Year-Old Children With Congenital Heart Disease: Prevalence and Risk Factors

et al. 2020

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Children with congenital heart disease (CHD) may be at increased risk for neurodevelopmental impairments. Long-term behavioral profiles and respective risk factors are less frequently described. The aim of this study was to evaluate multidimensional behavioral outcomes and associated medical, psychological, and social risk factors in children with complex CHD. At 10-years of age, 125 children with CHD were assessed for general behavioral difficulties, attention deficit hyperactivity disorder (ADHD)-related behavior, and social interaction problems and were compared to normative data. Medical and cardiac factors, IQ, maternal mental health at 4 years of age and parental socioeconomic status were tested as predictors for all behavioral outcomes. Children with CHD showed no significant differences in general behavioral difficulties. However, increased ADHD-related symptoms (p < 0.05) and difficulties in social interaction (p < 0.05) were observed. In 23% of the children, a combination of ADHD-related symptoms and social interaction problems was reported by parents. In multivariate analyses, IQ (p < 0.01) and maternal mental health (p < 0.03) at 4 years of age were found to be predictive for all behavioral outcomes at 10 years while medical and cardiac risk factors were not. Our findings reveal significant difficulties in ADHD-related symptoms and social interaction problems with a significant comorbidity. Behavioral difficulties were not detected with a screening tool but with disorder-specific questionnaires. Furthermore, we demonstrate the importance of maternal mental health during early childhood on later behavioral outcomes of children with CHD. This underlines the importance of identifying and supporting parents with mental health issues at an early stage in order to support the family and improve the child's neurodevelopment.

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“…Recently, Fourdain and colleagues described a substantial improvement of gross motor abilities in CINC patients aged up to 24 months, particularly in children at risk of motor delay who received physical therapy on a regular basis ( 35 ). Although these results suggest a positive impact of the CINC program, they could also be associated with spontaneous recovery after surgery ( 39 , 40 ). Further research is therefore needed to quantify the benefits of neurocardiac follow-up programs on neurodevelopment.…”

Section: Introductionmentioning

confidence: 79%

Impacts of an Interdisciplinary Developmental Follow-Up Program on Neurodevelopment in Congenital Heart Disease: The CINC Study

et al. 2020

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Objectives: This study investigates the impact of an early systematic interdisciplinary developmental follow-up and individualized intervention program on the neurodevelopment of children with complex congenital heart disease (CHD) who required cardiac surgery. Study Design: We prospectively enrolled 80 children with CHD: 41 were already followed at our neurocardiac developmental follow-up clinic from the age of 4 months, while 39 were born before the establishment of the program and therefore received standard health care. We conducted cognitive, motor, and behavioral assessments at 3 years of age. We used one-way multivariate analyses of variance to compare the neurodevelopmental outcome of both groups. Results: Between-group analyses revealed a distinct neurodevelopmental profile with clinically significant effect size ( P < 0.001, partial η 2 = 0.366). Children followed at our clinic demonstrated better receptive language performances ( P = 0.048) and tended to show higher scores on visuo-constructive tasks ( P = 0.080). Children who received standard health care exhibited greater performances in working memory tasks ( P = 0.032). We found no group differences on global intellectual functioning, gross and fine motor skills, and behaviors. Referral rates for specific remedial services were higher in patients followed at our neurocardiac clinic compared to the historical cohort ( P < 0.005). Conclusions: Overall, the impact of the developmental follow-up and individualized intervention program on neurodevelopmental outcomes remains subtle. Nevertheless, results, although limited by several factors, point toward an advantage for the children who took part in the program regarding receptive language skills over children who received standard health care. We hypothesize that group differences may be greater with growing age. Further research involving larger cohorts is needed to clearly assess the effectiveness of neurocardiac developmental follow-up programs at school age.

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Cohort and Individual Neurodevelopmental Stability between 1 and 6 Years of Age in Children with Congenital Heart Disease

Cited by 20 publications

References 20 publications

Impact of the COVID‐19 pandemic on children with and without risk for neurodevelopmental impairments

Impact of the COVID‐19 pandemic on children with and without risk for neurodevelopmental impairments

Social and Behavioral Difficulties in 10-Year-Old Children With Congenital Heart Disease: Prevalence and Risk Factors

Impacts of an Interdisciplinary Developmental Follow-Up Program on Neurodevelopment in Congenital Heart Disease: The CINC Study

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