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Randomized Controlled Trial
. 2014 Sep;165(3):490-496.e8.
doi: 10.1016/j.jpeds.2014.05.019. Epub 2014 Jun 19.

Factors associated with neurodevelopment for children with single ventricle lesions

Caren S Goldberg  1 , Minmin Lu  2 , Lynn A Sleeper  2 , William T Mahle  3 , J William Gaynor  4 , Ismee A Williams  5 , Kathleen A Mussatto  6 , Richard G Ohye  7 , Eric M Graham  8 , Deborah U Frank  9 , Jeffrey P Jacobs  10 , Catherine Krawczeski  11 , Linda Lambert  9 , Alan Lewis  12 , Victoria L Pemberton  13 , Renee Sananes  14 , Erica Sood  15 , Stephanie B Wechsler  16 , David C Bellinger  17 , Jane W Newburger  17 ; Pediatric Heart Network Investigators
Collaborators, Affiliations
Randomized Controlled Trial

Factors associated with neurodevelopment for children with single ventricle lesions

Caren S Goldberg et al. J Pediatr. 2014 Sep.

Abstract

Objective: To measure neurodevelopment at 3 years of age in children with single right-ventricle anomalies and to assess its relationship to Norwood shunt type, neurodevelopment at 14 months of age, and patient and medical factors.

Study design: All subjects in the Single Ventricle Reconstruction Trial who were alive without cardiac transplant were eligible for inclusion. The Ages and Stages Questionnaire (ASQ, n = 203) and other measures of behavior and quality of life were completed at age 3 years. Medical history, including measures of growth, feeding, and complications, was assessed through annual review of the records and phone interviews. The Bayley Scales of Infant Development, Second Edition (BSID-II) scores from age 14 months were also evaluated as predictors.

Results: Scores on each ASQ domain were significantly lower than normal (P < .001). ASQ domain scores at 3 years of age varied nonlinearly with 14-month BSID-II. More complications, abnormal growth, and evidence of feeding, vision, or hearing problems were independently associated with lower ASQ scores, although models explained <30% of variation. Type of shunt was not associated with any ASQ domain score or with behavior or quality-of-life measures.

Conclusion: Children with single right-ventricle anomalies have impaired neurodevelopment at 3 years of age. Lower ASQ scores are associated with medical morbidity, and lower BSID-II scores but not with shunt type. Because only a modest percentage of variation in 3-year neurodevelopmental outcome could be predicted from early measures, however, all children with single right-ventricle anomalies should be followed longitudinally to improve recognition of delays.

Trial registration: ClinicalTrials.gov NCT00115934.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Single Ventricle Reconstruction Extension Trial Neurodevelopmental Assessment at 3 Years
Figure 2
Figure 2. Relationship of Ages and Stages Domain Scores at 3 Years to 14-Month Bayley Scales of Infant Development-II
Three-year ASQ domains versus A, 1-month Psychomotor Development Index (PDI) and B, 14-month Mental Development Index (MDI). The solid line represents the locally weighted scatterplot smoothing curve. The dashed line denotes the fitted piecewise linear regression model, using a cut-point of A, PDI=70 and B, MDI=85. The R2 assesses the percentage of variability in the ASQ domain explained by PDI score modeled with a piecewise linear regression fit.
Figure 2
Figure 2. Relationship of Ages and Stages Domain Scores at 3 Years to 14-Month Bayley Scales of Infant Development-II
Three-year ASQ domains versus A, 1-month Psychomotor Development Index (PDI) and B, 14-month Mental Development Index (MDI). The solid line represents the locally weighted scatterplot smoothing curve. The dashed line denotes the fitted piecewise linear regression model, using a cut-point of A, PDI=70 and B, MDI=85. The R2 assesses the percentage of variability in the ASQ domain explained by PDI score modeled with a piecewise linear regression fit.
See this image and copyright information in PMC

References

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