Impact of cardiac surgical timing on the neurodevelopmental outcomes of newborns with Complex congenital heart disease (CHD)

Developmental and Psychological Concerns in Children With Complex Congenital Heart Disease: The Need for a Screening Program

AIM

Complex congenital heart disease (CHD) is associated with adverse neurodevelopmental and psychological outcomes. Limited Australian data exist regarding these outcomes or follow-up. This cross-sectional study aims to determine the prevalence of developmental and psychological concerns in South Australian children with complex CHD and concurrent developmental or psychological healthcare utilisation.

METHODS

Families of children with complex CHD aged between 3 years and 7 years 11 months undertook a series of validated screening questionnaires for development (Parents' Evaluation of Developmental Status [PEDS], Parents' Evaluation of Developmental Status-Developmental Milestones [PEDS:DM]) and mental health (Strengths and Difficulties Questionnaire [SDQ]). Demographic data, cardiac history, comorbidities, and current healthcare engagement was determined through standardised patient information questionnaires and medical records. Rates of developmental and psychological concern were determined and compared to Australian general population data.

RESULTS

Fifty-five participants enrolled in the study. The most common cardiac diagnoses were Transposition of the Great Arteries (n = 13) and Tetralogy of Fallot (n = 11). Predictive developmental domain/s of concern were highly prevalent utilising both PEDS (57%) and PEDS:DM (70%) screening tools, exceeding Australian population rates (22%). Psychological concern (28%) also exceeded Australian population data (10%). Nearly half of participants identified to have developmental or psychological concern/s had no current general paediatric, allied health or mental health professional engagement.

CONCLUSIONS

Developmental and psychological concerns detected on screening in children with complex CHD significantly exceed Australian general population prevalence rates. Without an established screening program, a large proportion of participants did not have active follow-up, indicating the importance of routine screening.

Parenting stress in infancy was associated with neurodevelopment in 24-month-old children with congenital heart disease

AIM

Having a child with congenital heart disease (CHD) is stressful for parents, but research on the impact this stress can have on child development has been lacking. We investigated the associations between parenting stress when children were infants and neurodevelopmental outcomes in toddlers with CHD.

METHODS

This study was carried out at the Neurocardiac Clinic at the Sainte-Justine University Hospital in Montréal, Canada. Patients born from 2012 to 2019 and followed up to 24 months of age were recruited. Parenting stress levels were measured when the child was 4-6 months and 24 months and the child's neurodevelopment was assessed at 24 months. Multiple linear regressions analyses were carried out.

RESULTS

We studied 100 children (56% boys) with CHD. Most of the parenting stress scores were below the clinical threshold. However, they accounted for a significant part of the variance in the children's cognitive (15%-16%), receptive language (14%-15%) and gross motor outcomes (15%-18%). They had no impact on the children's expressive language or fine motor outcomes.

CONCLUSION

Higher parenting stress was associated with poorer neurodevelopmental outcomes in toddlers with CHD. Early screening of parenting stress in CHD clinics is necessary to provide individualised intervention for parents and optimise neurodevelopmental outcomes in children.

Current research status and progress in neuropsychological development of children with congenital heart disease: A review

Children with congenital heart disease (CHD) are receiving widespread attention for their neuropsychological developmental issues, which include cognitive, adaptive, motor, speech, behavioral, and executive functioning deficits as well as autism spectrum disorders. Timely identification of risk factors influencing neuropsychological development and implementation of appropriate interventions are crucial for enhancing the neuropsychological outcomes of children with CHD, ultimately benefiting the children, their families, and society as a whole. This comprehensive review article aimed to explore the epidemiology, risk factors, assessment methods, and monitoring strategies of neuropsychological development in children with CHD. By providing a detailed examination of these factors, this review serves as a valuable resource for researchers and practitioners in the field, facilitating deeper understanding and more effective management of neuropsychological issues in this vulnerable population.

Top 100 Most Cited Papers on Multimodality Imaging for Complex Congenital Heart Disease. A Bibliometric Analysis

Complex congenital heart disease (CCHD) is a group of heart defects present at birth. Some imaging methods can support the diagnosis of these pathologies, such as echocardiography, computed tomography, and magnetic resonance imaging. This study aimed to perform a bibliometric analysis of the top 100 articles cited on CCHD. Articles from 2013 to 2023 found in Scopus were scanned using 15 CCHD topics titles crossed with echocardiography, computed tomography, and magnetic resonance imaging. Duplicated manuscripts were eliminated using Microsoft Excel software, and the publications were ranked according to their citation count. This study selected and analyzed the top 100 most cited English-language papers. The top 100 most cited publications accumulated 16,563 citations. The manuscript with the most citations obtained 1086, representing 6.55% of the total citations. The year 2014 had the highest number of publications, with 27 papers. The first authors had affiliations from 44 countries; the United States was the country that contributed the most, with 54 manuscripts. Boston Children's Hospital was the institution that provided more articles to the top 100. Finally, the Ebstein anomaly was the topic with the highest number of citations. This study identified the 100 most cited on CCHD, and the results obtained can provide practical guidance to clinicians and researchers to familiarize themselves with the most influential publications in this field.