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Observational Study
. 2023 Dec:263:113687.
doi: 10.1016/j.jpeds.2023.113687. Epub 2023 Aug 21.

Inpatient Screening for Early Identification of Developmental Risk in Infants with Congenital Heart Defects

Affiliations
Observational Study

Inpatient Screening for Early Identification of Developmental Risk in Infants with Congenital Heart Defects

Samantha C Butler et al. J Pediatr. 2023 Dec.

Abstract

Objective: To assess the utility of an inpatient standardized developmental screener for early identification of developmental risk in infants with a congenital heart defect (CHD).

Study design: This was a retrospective, observational study with convenience sample of postoperative infants with CHD (aged 3-12 months) who underwent neurodevelopmental screening with the Bayley Scales of Infant and Toddler Development Screening Test, Third Edition (Bayley-III Screener) just before discharge. Follow-up testing included outpatient Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) (12-42 mo).

Results: The Bayley-III Screener was administered to 325 infants at a median of 5 months, 8 days (IQR 3 months, 28 days, to 7 months, 17 days). Infants scored below age expectations on the Gross Motor (79%), Fine Motor (63%), Receptive Communication (50%), Expressive Communication (38%), and Cognitive (38%) domains. In each domain, children with CHD had greater rates of scores below expectations than the normative sample (each P <.001). The odds of scoring in a greater risk category were increased for infants with genetic syndromes and longer length of hospital stay across all domains. The outpatient Bayley-III (n = 74, 23% follow-up) was completed at a median of 19 months, 9 days (IQR: 17 months, 3 days, to 23 months, 37 days). Individuals falling in greater-risk categories on their initial Bayley-III Screener were significantly more likely to have worse performance on their follow-up outpatient Bayley-III (each domain P < .01).

Conclusions: Inpatient standardized neurodevelopmental screening provides important clinical utility in identifying infants at risk for developmental concern, allows for provision of recommendations for developmental services, and potentially overcomes barriers often noted in returning for outpatient post-discharge assessments.

Keywords: Bayley-III screener; cardiac; developmental delay; neurodevelopment.

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Conflict of interest statement

Declaration of Competing Interest The research work was supported by the Kenrose Kitchen Table Foundation and the Benderson Family Heart Center at Boston Children’s Hospital Strategic Investment Award. The authors declare no conflicts of interest.

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