@Article{chd.12686,
AUTHOR = {Samantha C. Butler, Anjali Sadhwani, Christian Stopp, Jayne Singer, David Wypij, Carolyn Dunbar‐Masterson, Janice Ware, Jane W. Newburger},
TITLE = {Neurodevelopmental assessment of infants with congenital heart disease in the early postoperative period},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {2},
PAGES = {236--245},
URL = {http://www.techscience.com/schd/v14n2/38756},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> 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.<br/>
<b>Outcome measures:</b> 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.<br/>
<b>Results:</b> 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).<br/>
<b>Conclusion:</b> 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.},
DOI = {10.1111/chd.12686}
}