Background: The current literature on neurodevelopment (ND) in pediatric cardiology patients has largely revolved around specific ND outcomes. Children with congenital heart defects (CHD) have a higher risk for acquiring developmental disabilities due to many factors including prenatal cerebral perfusion, cyanosis, and exposure to cardiopulmonary bypass. Routine developmental evaluations throughout childhood can increase the chances of identifying these deficits, allowing early intervention. We sought to evaluate referral to early intervention after congenital heart surgery and associated variables. Methods: We performed a retrospective chart review of pediatric patients with CHD requiring cardiac surgery within the first year of life from 1/1/13-12/31/18. Evaluated variables included whether the diagnosis was made prenatally, birth weight, gestational age at birth, presence of other genetic abnormalities, length of stay, number of catheterizations, mortality, ND referral, evaluation and follow-up, and distance for ND evaluation from patient’s home. Results: Of 151 patients with CHD, 57 (37.7%) were female and 111 (73%) were prenatally diagnosed. Sixteen (10.6%) had additional genetic abnormalities. 58 (38.4%) had single ventricle heart disease. Twenty (13.2%) died prior to six months of age. Of the total group, 64 (42.4%) were referred to ND services, and 60 (39.7%) patients accessed ND services, at a median age of 8.4 months and median distance of 62.1 miles from their home. Patients with single ventricle anatomy had a significantly increased rate of ND referral (50% vs 31%, p<.05) for early intervention in comparison to those with two ventricles. Conclusion: Despite the risk for ND challenges, only 42.4% of eligible children with CHD were referred to Early Intervention. Patients with single ventricle anatomy who maintain the highest risk for poor ND outcomes had a 50% referral rate. Furthermore, patients with two ventricle physiology who also carry risk for ND delays were even less likely to be referred for evaluation. When referred, 93.8% of patients accessed ND services. Further investigation of barriers to referral as well as results of CHD specific ND assessments are ongoing.
Single Center Experience With Neurodevelopmental Follow-Up In Pediatric Cardiac Patients
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Christina Ronai, Erin J. Madriago, Tiffany L. Lee, Sage Saxton; Single Center Experience With Neurodevelopmental Follow-Up In Pediatric Cardiac Patients. Pediatrics March 2021; 147 (3_MeetingAbstract): 365–367. 10.1542/peds.147.3MA4.365b
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