Samantha C Butler1,2, Anjali Sadhwani1,2, Christian Stopp3, Jayne Singer1,4,2, David Wypij3,5,6, Carolyn Dunbar-Masterson3, Janice Ware1,4,2, Jane W Newburger3,5. 1. Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts. 2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. 3. Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. 4. Developmental Medicine Center, Boston Children's Hospital, Boston, Massachusetts. 5. Department of Pediatrics, Harvard Medical School, Boston, Massachusetts. 6. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Abstract
OBJECTIVE: Mortality rates for children with congenital heart disease (CHD) have significantly declined, resulting in a growing population with associated neurodevelopmental disabilities. American Heart Association guidelines recommend systematic developmental screening for children with CHD. The present study describes results of inpatient newborn neurodevelopmental assessment of infants after open heart surgery. OUTCOME MEASURES: We evaluated the neurodevelopment of a convenience sample of high-risk infants following cardiac surgery but before hospital discharge using an adaptation of the Newborn Behavioral Observation. Factor analysis examined relationships among assessment items and consolidated them into domains of development. RESULTS: We assessed 237 infants at a median of 11 days (interquartile range [IQR]: 7-19 days) after cardiac surgery and median corrected age of 21 days (IQR: 13-33 days). Autonomic regulation was minimally stressed or well organized in 14% of infants. Upper and lower muscle tone was appropriate in 33% and 35%, respectively. Appropriate response to social stimulation ranged between 7% and 12% depending on task, and state regulation was well organized in 14%. The vast majority (87%) required enhanced examiner facilitation for participation. Factor analyses of assessment items aligned into four domains of development (autonomic, motor, oral motor, and attention organization). CONCLUSION: At discharge, postoperative infants with CHD had impairments in autonomic, motor, attention, and state regulation following cardiac surgery. Findings highlight the challenges faced by children with CHD relative to healthy peers, suggesting that neurodevelopmental follow-up and intervention should begin early in infancy.
OBJECTIVE: Mortality rates for children with congenital heart disease (CHD) have significantly declined, resulting in a growing population with associated neurodevelopmental disabilities. American Heart Association guidelines recommend systematic developmental screening for children with CHD. The present study describes results of inpatient newborn neurodevelopmental assessment of infants after open heart surgery. OUTCOME MEASURES: We evaluated the neurodevelopment of a convenience sample of high-risk infants following cardiac surgery but before hospital discharge using an adaptation of the Newborn Behavioral Observation. Factor analysis examined relationships among assessment items and consolidated them into domains of development. RESULTS: We assessed 237 infants at a median of 11 days (interquartile range [IQR]: 7-19 days) after cardiac surgery and median corrected age of 21 days (IQR: 13-33 days). Autonomic regulation was minimally stressed or well organized in 14% of infants. Upper and lower muscle tone was appropriate in 33% and 35%, respectively. Appropriate response to social stimulation ranged between 7% and 12% depending on task, and state regulation was well organized in 14%. The vast majority (87%) required enhanced examiner facilitation for participation. Factor analyses of assessment items aligned into four domains of development (autonomic, motor, oral motor, and attention organization). CONCLUSION: At discharge, postoperative infants with CHD had impairments in autonomic, motor, attention, and state regulation following cardiac surgery. Findings highlight the challenges faced by children with CHD relative to healthy peers, suggesting that neurodevelopmental follow-up and intervention should begin early in infancy.
Authors: Lindsey Gakenheimer-Smith; Kristi Glotzbach; Zhining Ou; Angela P Presson; Michael Puchalski; Courtney Jones; Linda Lambert; Claudia Delgado-Corcoran; Aaron Eckhauser; Thomas Miller Journal: J Pediatr Date: 2019-08-08 Impact factor: 4.406
Authors: Samantha C Butler; Anjali Sadhwani; Valerie Rofeberg; Adam R Cassidy; Jayne Singer; Johanna Calderon; David Wypij; Jane W Newburger; Caitlin K Rollins Journal: Dev Med Child Neurol Date: 2021-12-18 Impact factor: 4.864
Authors: Thomas A Miller; Amy J Lisanti; Madolin K Witte; Justin J Elhoff; William T Mahle; Karen C Uzark; Nneka Alexander; Samantha C Butler Journal: J Pediatr Date: 2020-03-05 Impact factor: 4.406
Authors: Débora Cañizo Vázquez; Stephanie M Hadley; Marta Pérez Ordóñez; Miriam Lopez-Abad; Anna Valls; Marta López Viñals; Bosco A Moscoso; Sergio Benito Fernandez; Marta Camprubí-Camprubí; Joan Sanchez-de-Toledo Journal: Antioxidants (Basel) Date: 2022-02-28