Abstract 14337: Preschool Neurodevelopmental Outcomes in Children With Congenital Heart Disease After Surgical Palliation

Introduction: Children with congenital heart disease (CHD) are at risk for neurodevelopmental (ND) delays. The American Heart Association (AHA) recommends serial ND evaluation for children with CHD. This study reports preschool ND testing results of children with CHD. Methods: Children with CHD meeting the AHA high-risk criteria for ND delay were referred for evaluation at 4-5 years of age. Testing included standardized neuropsychological measures. Parents completed measures of adaptive behavior, emotional functioning, social skills, attention, language, family functioning and child quality of life (QOL). Patient scores and parent ratings were compared to test norms and were classified as: average (within one SD of test mean); at risk (1-2 SDs from the test mean); and impaired (>2SD from test mean). T-tests were used to compare scores based on cardiac anatomy (1V vs. 2V). Results: Data on 102 consecutively referred patients were analyzed. Median age at first cardiac operation was 13 days. Mean age at testing was 4.5 years (range 4 to 5.9). Patients had the following characteristics: 1V anatomy 33%; male 63%; prenatal diagnosis 54%; premature 16%; non-white/Hispanic race 16%; and comorbidities: medical 26%, genetic 17%. ND test scores were lower than norms for IQ, pre-spelling, visual-motor, fine motor, adaptive behavior, and social skills, and higher than norms for attention problems; however, means were within one SD of norms for all measures. ND scores did not differ based on cardiac anatomy (1V vs. 2V); however, parents of children with 1V reported lower child QOL scores and worse family functioning than parents of children with 2V (p<0.05). The % of children within the normal, at risk, and impaired range on ND measures is presented in the figure. Conclusion: ND outcome for preschool aged children identified more delays than expected in some areas. Most deficits were mild and may not be detected without formal testing. ND outcome was not related to cardiac anatomy.