Neurobehavioral evaluation of neonates with congenital heart disease: a cohort study

Abstract

Neonates with congenital heart disease demonstrate different neurobehavioral performance than typically developing neonates. Evaluation of neonatal neurobehavioral performance provides an opportunity to identify neurodevelopmental variability early. Identification of neurobehavioral performance variability allows targeted interactions and therapy.

Neurodevelopmental assessment of infants with congenital heart disease in the early postoperative period

“…Similarly, previous studies, with smaller sample sizes, reported that CHD infants before and after surgery demonstrated atypical behavioral responses, including poor visual orienting, disorganized state, increased stress, and difficulty with regulation . Hogan et al demonstrated lower ability to sustain attention with increased need for support from the examiner to maintain attention and to soothe the infant with CHD . Overall, infants with CHD interact less with their environment because of their abnormalities with arousal, attention, and difficulty with state regulation.…”

“…24,25 Hogan et al demonstrated lower ability to sustain attention with increased need for support from the examiner to maintain attention and to soothe the infant with CHD. 26 Overall, infants with CHD interact less with their environment because of their abnormalities with arousal, attention, and difficulty with state regulation. Als et al propose that poor state organization in preterm infants serves as a protection for shutting out excessive stimulation in an attempt to maintain physiologic homeostasis.…”

“…studies have characterized the developmental functioning of young infants following cardiac surgery and just prior to discharge home. Hogan et al demonstrated lower ability to sustain attention with increased need for support from the examiner to maintain attention and to soothe the infant with CHD 26. Our assessment monitored behavioral subsystems of the infant in interaction with each other and the environment in order to provide support for the infant during assessment.…”

Clinical assessment of early brain function in infants with congenital heart disease

“…The retrospective study by Franckx et al 3 aims to advance our understanding of a battery of clinical assessments (e.g. cranial ultrasound, magnetic resonance imaging [MRI], somatosensory evoked potentials) in identifying the long-term neurological outcome of infants born preterm at risk of developmental disabilities.…”

“…Hogan et al used the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) to assess neurobehavioral integrity in 67 infants with various types of CHD, before and after surgery. The NNNS is a standardized assessment tool to evaluate at‐risk infants and is associated with neurodevelopmental outcome at 18 months in drug‐exposed neonates and in neonates born preterm.…”