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. 1999 Jun;80(6):511–516. doi: 10.1136/adc.80.6.511

Controlled study of preschool development after surgery for congenital heart disease

J Wray 1, T Sensky 1
PMCID: PMC1717961  PMID: 10331998

Abstract

AIM—Research into intellectual impairment among children with congenital heart disease has focused mainly on older children. This study was designed to determine whether previous findings are applicable to preschool children.
METHODS—Three groups of children under 31/2 years old were assessed immediately before treatment and 12 months later: a group with congenital heart disease awaiting surgery, another awaiting bone marrow transplantation, and a healthy comparison group.
RESULTS—Although the means of the three groups were within the normal range, preoperatively the cardiac and transplant groups showed deficits compared with the healthy controls. Postoperatively, continuing developmental deficits were significant only in the children with cyanotic lesions.
CONCLUSIONS—Conclusions about intellectual development in older children with congenital heart disease do not apply to preschool children. Before corrective surgery, chronic illness itself appears to be the predominant influence on development. Postoperatively, cyanotic and acyanotic lesions are associated with different short term outcomes.



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Selected References

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  1. ACK M., MILLER I., WEIL W. B., Jr Intelligence of children with diabetes mellitus. Pediatrics. 1961 Nov;28:764–770. [PubMed] [Google Scholar]
  2. Aisenberg R. B., Rosenthal A., Nadas A. S., Wolff P. H. Developmental delay in infants with congenital heart disease. Correlation with hypoxemia and congestive heart failure. Pediatr Cardiol. 1982;3(2):133–137. doi: 10.1007/BF02312960. [DOI] [PubMed] [Google Scholar]
  3. Aisenberg R. B., Rosenthal A., Wolff P. H., Nadas A. S. Hypoxemia and critical flicker frequency in congenital heart disease. Am J Dis Child. 1974 Sep;128(3):335–338. doi: 10.1001/archpedi.1974.02110280065008. [DOI] [PubMed] [Google Scholar]
  4. Aram D. M., Ekelman B. L., Ben-Shachar G., Levinsohn M. W. Intelligence and hypoxemia in children with congenital heart disease: fact or artifact? J Am Coll Cardiol. 1985 Oct;6(4):889–893. doi: 10.1016/s0735-1097(85)80500-3. [DOI] [PubMed] [Google Scholar]
  5. BRET J., KOHLER C. Incidences neuropsychiatriques des cardiopathies congénitales chez l'enfant. Pediatrie. 1956;11(1):59–68. [PubMed] [Google Scholar]
  6. Balestrini M. R., Zanette M., Micheli R., Fornari M., Solero C. L., Broggi G. Hemispheric cerebral tumors in children. Long-term prognosis concerning survival rate and quality of life--considerations on a series of 64 cases operated upon. Childs Nerv Syst. 1990 May;6(3):143–147. doi: 10.1007/BF00308491. [DOI] [PubMed] [Google Scholar]
  7. Bidder R. T., Bryant G., Gray O. P. Benefits to Down's syndrome children through training their mothers. Arch Dis Child. 1975 May;50(5):383–386. doi: 10.1136/adc.50.5.383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cravioto J., Delicardie E. R. Mental performance in school age children. Findings after recovery from early severe malnutrition. Am J Dis Child. 1970 Nov;120(5):404–410. doi: 10.1001/archpedi.1970.02100100068004. [DOI] [PubMed] [Google Scholar]
  9. D'Antonio I. J. Mother's responses to the functioning and behavior of cardiac children in child-rearing situations. Matern Child Nurs J. 1976 WINTER;5(4):iii-viii, 207-59. [PubMed] [Google Scholar]
  10. DeMaso D. R., Beardslee W. R., Silbert A. R., Fyler D. C. Psychological functioning in children with cyanotic heart defects. J Dev Behav Pediatr. 1990 Dec;11(6):289–294. [PubMed] [Google Scholar]
  11. Dikmen S., Matthews C. G., Harley J. P. The effect of early versus late onset of major motor epilepsy upon cognitive-intellectual performance. Epilepsia. 1975 Mar;16(1):73–81. doi: 10.1111/j.1528-1157.1975.tb04723.x. [DOI] [PubMed] [Google Scholar]
  12. Eiser C., Lansdown R. Retrospective study of intellectual development in children treated for acute lymphoblastic leukaemia. Arch Dis Child. 1977 Jul;52(7):525–529. doi: 10.1136/adc.52.7.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Eiser C. Psychological sequelae of brain tumours in childhood: a retrospective study. Br J Clin Psychol. 1981 Feb;20(Pt 1):35–38. doi: 10.1111/j.2044-8260.1981.tb00493.x. [DOI] [PubMed] [Google Scholar]
  14. Feldt R. H., Ewert J. C., Stickler G. B., Weidman W. H. Children with congenital heart disease. Motor development and intelligence. Am J Dis Child. 1969 Mar;117(3):281–287. doi: 10.1001/archpedi.1969.02100030283005. [DOI] [PubMed] [Google Scholar]
  15. Galler J. R., Ramsey F., Solimano G., Lowell W. E., Mason E. The influence of early malnutrition on subsequent behavioral development. I. Degree of impairment in intellectual performance. J Am Acad Child Psychiatry. 1983 Jan;22(1):8–15. doi: 10.1097/00004583-198301000-00002. [DOI] [PubMed] [Google Scholar]
  16. Gonzalez-Pardo L., Miles M., Taylor M., Mattioli L. Congenital heart disease: developmental and neurological evaluation in preschool children. J Kans Med Soc. 1981 Mar;82(3):115-8, 136. [PubMed] [Google Scholar]
  17. Gudermuth S. Mothers' reports of early experiences of infants with congenital heart disease. Matern Child Nurs J. 1975 Fall;4(3):155–164. [PubMed] [Google Scholar]
  18. Hanson R., Smith J. A., Hume W. Achievement of infants on items of the Griffiths scales: 1980 compared with 1950. Child Care Health Dev. 1985 Mar-Apr;11(2):91–104. doi: 10.1111/j.1365-2214.1985.tb00454.x. [DOI] [PubMed] [Google Scholar]
  19. Hesz N., Clark E. B. Cognitive development in transposition of the great vessels. Arch Dis Child. 1988 Feb;63(2):198–200. doi: 10.1136/adc.63.2.198. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. LANDTMAN B., VALANNE E., PENTTI R., AUKEE M. Psychosomatic behaviour of children with congenital heart disease. Pre- and postoperative studies of eighty-four cases. Ann Paediatr Fenn. 1960;6(Suppl 15):1–78. [PubMed] [Google Scholar]
  21. Linde L. M., Rasof B., Dunn O. J. Longitudinal studies of intellectual and behavioral development in children with congenital heart disease. Acta Paediatr Scand. 1970 Mar;59(2):169–176. doi: 10.1111/j.1651-2227.1970.tb08984.x. [DOI] [PubMed] [Google Scholar]
  22. Linde L. M., Rasof B., Dunn O. J., Rabb E. Attitudinal factors in congenital heart disease. Pediatrics. 1966 Jul;38(1):92–101. [PubMed] [Google Scholar]
  23. Ludman L., Spitz L., Lansdown R. Intellectual development at 3 years of age of children who underwent major neonatal surgery. J Pediatr Surg. 1993 Feb;28(2):130–134. doi: 10.1016/s0022-3468(05)80257-x. [DOI] [PubMed] [Google Scholar]
  24. Mendoza J. C., Wilkerson S. A., Reese A. H. Follow-up of patients who underwent arterial switch repair for transposition of the great arteries. Am J Dis Child. 1991 Jan;145(1):40–43. doi: 10.1001/archpedi.1991.02160010042013. [DOI] [PubMed] [Google Scholar]
  25. Newburger J. W., Silbert A. R., Buckley L. P., Fyler D. C. Cognitive function and age at repair of transposition of the great arteries in children. N Engl J Med. 1984 Jun 7;310(23):1495–1499. doi: 10.1056/NEJM198406073102303. [DOI] [PubMed] [Google Scholar]
  26. O'Dougherty M., Wright F. S., Garmezy N., Loewenson R. B., Torres F. Later competence and adaptation in infants who survive severe heart defects. Child Dev. 1983 Oct;54(5):1129–1142. [PubMed] [Google Scholar]
  27. Oates R. K., Simpson J. M., Cartmill T. B., Turnbull J. A. Intellectual function and age of repair in cyanotic congenital heart disease. Arch Dis Child. 1995 Apr;72(4):298–301. doi: 10.1136/adc.72.4.298. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Offord D. R., Cross L. A., Andrews E. J., Aponte J. F. Perceived and actual severity of congenital heart disease and effect on family life. Psychosomatics. 1972 Nov-Dec;13(6):390–396. doi: 10.1016/S0033-3182(72)71390-0. [DOI] [PubMed] [Google Scholar]
  29. PRUGH D. G., STAUB E. M., SANDS H. H., KIRSCHBAUM R. M., LENIHAN E. A. A study of the emotional reactions of children and families to hospitalization and illness. Am J Orthopsychiatry. 1953 Jan;23(1):70–106. doi: 10.1111/j.1939-0025.1953.tb00040.x. [DOI] [PubMed] [Google Scholar]
  30. Polinsky M. S., Kaiser B. A., Stover J. B., Frankenfield M., Baluarte H. J. Neurologic development of children with severe chronic renal failure from infancy. Pediatr Nephrol. 1987 Apr;1(2):157–165. doi: 10.1007/BF00849288. [DOI] [PubMed] [Google Scholar]
  31. Rasof B., Linde L. M., Dunn O. J. Intellectual development in children with congenital heart disease. Child Dev. 1967 Dec;38(4):1043–1053. [PubMed] [Google Scholar]
  32. Samango-Sprouse C., Suddaby E. C. Developmental concerns in children with congenital heart disease. Curr Opin Cardiol. 1997 Jan;12(1):91–98. [PubMed] [Google Scholar]
  33. Silbert A., Wolff P. H., Mayer B., Rosenthal A., Nadas A. S. Cyanotic heart disease and psychological development. Pediatrics. 1969 Feb;43(2):192–200. [PubMed] [Google Scholar]
  34. Singer L. T., Fagan J. F., 3rd Cognitive development in the failure-to-thrive infant: a three-year longitudinal study. J Pediatr Psychol. 1984 Sep;9(3):363–383. doi: 10.1093/jpepsy/9.3.363. [DOI] [PubMed] [Google Scholar]
  35. Smith J. A., Bidder R. T., Gardner S. M., Gray O. P. Griffiths Scales of Mental Development and different users. Child Care Health Dev. 1980 Jan-Feb;6(1):11–16. doi: 10.1111/j.1365-2214.1980.tb00792.x. [DOI] [PubMed] [Google Scholar]
  36. So S. K., Chang P. N., Najarian J. S., Mauer S. M., Simmons R. L., Nevins T. E. Growth and development in infants after renal transplantation. J Pediatr. 1987 Mar;110(3):343–350. doi: 10.1016/s0022-3476(87)80491-2. [DOI] [PubMed] [Google Scholar]
  37. Stewart S. M., Uauy R., Kennard B. D., Waller D. A., Benser M., Andrews W. S. Mental development and growth in children with chronic liver disease of early and late onset. Pediatrics. 1988 Aug;82(2):167–172. [PubMed] [Google Scholar]
  38. Stewart S. M., Uauy R., Waller D. A., Kennard B. D., Andrews W. S. Mental and motor development correlates in patients with end-stage biliary atresia awaiting liver transplantation. Pediatrics. 1987 Jun;79(6):882–888. [PubMed] [Google Scholar]
  39. Stewart S. M., Uauy R., Waller D. A., Kennard B. D., Benser M., Andrews W. S. Mental and motor development, social competence, and growth one year after successful pediatric liver transplantation. J Pediatr. 1989 Apr;114(4 Pt 1):574–581. doi: 10.1016/s0022-3476(89)80696-1. [DOI] [PubMed] [Google Scholar]
  40. Vernon D. T., Schulman J. L., Foley J. M. Changes in children's behavior after hospitalization. Some dimensions of response and their correlates. Am J Dis Child. 1966 Jun;111(6):581–593. doi: 10.1001/archpedi.1966.02090090053003. [DOI] [PubMed] [Google Scholar]

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