Line Marie Holst1, Faridis Serrano2, Lara Shekerdemian2, Hanne Berg Ravn1, Danielle Guffey3, Nancy S Ghanayem2, Sonia Monteiro4. 1. Department of Cardiothoracic Anaesthesiology, Copenhagen University Hospital, Copenhagen, Denmark. 2. Section of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. 3. Dan L. Duncan Institute for Clinical and Translational Research Houston, Baylor College of Medicine, Houston, Texas. 4. Section of Developmental Pediatrics, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
Abstract
OBJECTIVE: To investigate the impact of feeding mode on neurodevelopmental outcomes in children with congenital heart defects. DESIGN: A retrospective cohort study of 208 children with congenital heart disease (CHD), who had surgery from 1 January 2013 until 31 December 2016 at Texas Children's Hospital, Houston, TX, US. SETTINGS: University Hospital, Developmental Outcome Clinic. OUTCOMES MEASURES: Standardized cognitive scores were assessed with Capute Scales and motor development with Revised Gesell Developmental Schedules. We analyzed anthropometrics, mode of feeding, surgical complexity, syndrome, and gender as predictors of developmental outcomes at four time points: hospital discharge, and 6, 12, and 24 months of age. RESULTS: Mode of feeding is associated with neurodevelopmental outcome in children with CHD. Children on enteral feeding tubes had significantly lower developmental quotient (DQ) scores in cognition, communication, and motor function at 12 and 24 months compared to orally fed children. There were greater proportions of developmental delays (DQ < 70) in enteral tube fed children at the 6, 12, and 24 months visits. Further, there was a strong association between presence of enteral feeding tube, syndrome, and developmental outcome. Greater surgical complexity, weight gain and ethnicity were not associated with the developmental outcomes. CONCLUSIONS: Our findings suggest that the presence of an enteral feeding tube following corrective congenital heart surgery are at increased risk of neurodevelopmental delays at 12 and 24 months.
OBJECTIVE: To investigate the impact of feeding mode on neurodevelopmental outcomes in children with congenital heart defects. DESIGN: A retrospective cohort study of 208 children with congenital heart disease (CHD), who had surgery from 1 January 2013 until 31 December 2016 at Texas Children's Hospital, Houston, TX, US. SETTINGS: University Hospital, Developmental Outcome Clinic. OUTCOMES MEASURES: Standardized cognitive scores were assessed with Capute Scales and motor development with Revised Gesell Developmental Schedules. We analyzed anthropometrics, mode of feeding, surgical complexity, syndrome, and gender as predictors of developmental outcomes at four time points: hospital discharge, and 6, 12, and 24 months of age. RESULTS: Mode of feeding is associated with neurodevelopmental outcome in children with CHD. Children on enteral feeding tubes had significantly lower developmental quotient (DQ) scores in cognition, communication, and motor function at 12 and 24 months compared to orally fed children. There were greater proportions of developmental delays (DQ < 70) in enteral tube fed children at the 6, 12, and 24 months visits. Further, there was a strong association between presence of enteral feeding tube, syndrome, and developmental outcome. Greater surgical complexity, weight gain and ethnicity were not associated with the developmental outcomes. CONCLUSIONS: Our findings suggest that the presence of an enteral feeding tube following corrective congenital heart surgery are at increased risk of neurodevelopmental delays at 12 and 24 months.