Neuromotor performance in infants before and after early open-heart surgery and risk factors for delayed development at 6 months of age.
Cardiol Young
; 29(2): 100-109, 2019 Feb.
Article
em En
| MEDLINE
| ID: mdl-30352635
ABSTRACT
BACKGROUND:
Early identification of infants with CHD at heightened risk of developmental delays can inform surveillance priorities. This study investigated pre-operative and post-operative neuromotor performance in infants undergoing open-heart surgery, and their developmental status at 6 months of age, to identify risk factors and inform care pathways.METHODS:
Infants undergoing open-heart surgery before 4 months of age were recruited into a prospective cohort study. Neuromotor performance was assessed pre-operatively and post-operatively using the Test of Infant Motor Performance and Prechtl's Assessment of General Movements. Development was assessed at 6 months of age using the Ages and Stages Questionnaire third edition. Pre-operative and post-operative General Movements performance was compared using McNemar's test and test of infant motor performance z-scores using Wilcoxon's signed rank test. Risk factors for delayed development at 6 months were explored using logistic regression.RESULTS:
Sixty infants were included in this study. In the 23 (38%) infants. A total of 60 infants were recruited. In the 23 (38%) infants assessed pre-operatively, there was no significant difference between pre- and post-operative performance on the GMs (p=0.63) or TIMP (p=0.28). At discharge, 15 (26%) infants presented with abnormal GMs, and the median TIMP z-score was -0.93 (IQR -1.4 to -0.69). At 6 months, 28 (52.8%) infants presented with gross motor delay on the ASQ-3, significantly negatively associated with gestational age (p=0.03), length of hospital stay (p=0.04) and discharge TIMP score (p=0.01).CONCLUSIONS:
Post-operative assessment using the GMs and TIMP may be useful to identify infants requiring individualised care and targeted developmental follow-up. Long-term developmental surveillance beyond 6 months of age is recommended.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Desenvolvimento Infantil
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Medição de Risco
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Transtornos das Habilidades Motoras
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Transtornos do Neurodesenvolvimento
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Cardiopatias Congênitas
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Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Etiology_studies
/
Guideline
/
Incidence_studies
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Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Infant
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Male
/
Newborn
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Cardiol Young
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
PEDIATRIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Austrália