Open Access

ARTICLE

Neurodevelopmental outcomes at 2 and 4 years in children with congenital heart disease

Cheryl L. Brosig^1,2, Laurel Bear^1,2, Sydney Allen¹, Pippa Simpson¹, Liyun Zhang¹, Michele Frommelt^1,2, Kathleen A. Mussatto²

1 Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
2 Herma Heart Institute, Children’s Hospital of Wisconsin, Milwaukee, Wisconsin

* Corresponding Author: Cheryl Brosig, Medical College of Wisconsin, Department of Pediatrics, 8701 Watertown Plank Road, Milwaukee, WI 53226. Email:

Congenital Heart Disease 2018, 13(5), 700-705. https://doi.org/10.1111/chd.12632

Abstract

Background and Objectives: Children with congenital heart disease (CHD) are at risk for neurodevelopmental (ND) delays. The purpose of this study is to compare the ND testing results of children with CHD at 2 and 4 years of age and determine if rates of ND delays change over time.
Methods: Children with CHD completed the Bayley Scales of Infant Development‐III (BSID‐III) at 2 years of age, and standardized neuropsychological measures at 4 years. Scores were compared with test norms and were classified as: average (within one SD of test mean); at risk (1‐2 SDs from the test mean); and delayed (>2 SD from test mean). Pearson correlations and McNemar’s exact tests were performed to deter‐ mine the relationship between test scores at the two times of assessment.
Results: Sixty‐four patients completed evaluations at 24 ± 3 months of age and 4 years of age. BSID‐III cognitive and fine motor scores were correlated with pre‐ school IQ and fine motor scores, r = .75 to .87, P < .0001. Agreement in score catego‐ ries was 79% for cognitive and 61% for fine motor. More patients had at risk or delayed scores at age 4 vs age 2 (P ≤ .01).
Conclusion(s): Despite significant correlations between 2‐ and 4‐year‐old test scores, many patients who scored in the average range at age 2 showed deficits at age 4. BSID‐III scores at age 2 may underestimate delays. Therefore, longitudinal ND as‐ sessment is recommended.

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