Perioperative Course and Socioeconomic Status Predict Long-Term Neurodevelopment Better Than Perioperative Conventional Neuroimaging in Children with Congenital Heart Disease

The objective of the study was to compare the use of neonatal conventional brain magnetic resonance imaging (MRI) with that of clinical factors and socioeconomic status (SES) to predict long-term neurodevelopment in children with severe congenital heart disease (CHD). In this prospective cohort stud...

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Bibliographic Details
Published in:The Journal of pediatrics 2022-12, Vol.251, p.140-148.e3
Main Authors: Neukomm, Astrid, Ehrler, Melanie, Feldmann, Maria, Chaouch, Aziz, Knirsch, Walter, Hagmann, Cornelia, Jakab, Andras, Latal, Beatrice
Format: Article
Language:English
Subjects:
Brain Injuries - pathology
brain injury
brain volume
Child
Heart Defects, Congenital - diagnostic imaging
Heart Defects, Congenital - surgery
Humans
Infant
Infant, Newborn
length of hospital stay
MRI
Neuroimaging
Prospective Studies
Social Class
socioeconomic status
Transposition of Great Vessels - surgery
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Summary:The objective of the study was to compare the use of neonatal conventional brain magnetic resonance imaging (MRI) with that of clinical factors and socioeconomic status (SES) to predict long-term neurodevelopment in children with severe congenital heart disease (CHD). In this prospective cohort study, perioperative MRIs were acquired in 57 term-born infants with CHD undergoing cardiopulmonary bypass surgery during their first year of life. Total brain volume (TBV) was measured using an automated method. Brain injury severity (BIS) was assessed by an established scoring system. The neurodevelopmental outcome was assessed at 6 years using standardized test batteries. A multiple linear regression model was used for cognitive and motor outcomes with postoperative TBV, perioperative BIS, CHD complexity, length of hospital stay, and SES as covariates. CHD diagnoses included univentricular heart defect (n = 15), transposition of the great arteries (n = 33), and acyanotic CHD (n = 9). Perioperative moderate-to-severe brain injury was detected in 15 (26%) patients. The total IQ was similar to test norms (P = .11), whereas the total motor score (P 
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2022.07.032