A Comparison of Developmental Outcomes of Adolescent Neonatal Intensive Care Unit Survivors Born with a Congenital Heart Defect or Born Preterm - 07/12/18

Doi : 10.1016/j.jpeds.2018.11.002

Kaitlyn Easson, BScH ^1,², Noémi Dahan-Oliel, PhD ^3,⁴, Charles Rohlicek, MDCM, PhD ⁵, Sossy Sahakian, MSc ¹, Marie Brossard-Racine, PhD ^1,^2,^3,⁶, Barbara Mazer, PhD ³, Patricia Riley, MD ⁷, Désirée B. Maltais, PhD ⁸, Line Nadeau, PhD ⁸, Sean Hatzigeorgiou, BSc ⁹, Norbert Schmitz, PhD ¹⁰, Annette Majnemer, PhD ^1,^3,^6,^*
¹ Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
² Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Québec, Canada
³ School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada
⁴ Shriners Hospitals for Children, Montreal, Québec, Canada
⁵ Department of Cardiology, Montreal Children's Hospital, Montreal, Québec, Canada
⁶ Department of Pediatrics, Division of Child Neurology, McGill University, Montreal, Québec, Canada
⁷ Department of Pediatrics, Montreal Children's Hospital, Montreal, Québec, Canada
⁸ Department of Rehabilitation, Université Laval, Québec City, Québec, Canada
⁹ Department of Physiology, McGill University, Montreal, Québec, Canada
¹⁰ Department of Psychiatry, McGill University, Montreal, Québec, Canada

^*Reprint requests: Annette Majnemer, PhD, 5252 boul. de Maisonneuve Ouest—3F.44, Montreal, QC H3G 2M, Canada.5252 boul. de Maisonneuve Ouest—3F.44MontrealQCH3G 2MCanada

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 07 December 2018

Abstract

Objective

To compare cognitive, motor, behavioral, and functional outcomes of adolescents born with a congenital heart defect (CHD) and adolescents born preterm.

Study design

Adolescents (11-19 years old) born with a CHD requiring open-heart surgery during infancy (n = 80) or born preterm ≤29 weeks of gestational age (n = 128) between 1991 and 1999 underwent a cross-sectional evaluation of cognitive (Leiter International Performance Scale-Revised), motor (Movement Assessment Battery for Children-II), behavioral (Strengths and Difficulties Questionnaire), and functional (Vineland Adaptive Behavior Scale-II) outcomes. Independent samples t tests and Pearson χ² or Fisher exact tests were used to compare mean scores and proportions of impairment, respectively, between groups.

Results

Adolescents born with a CHD and adolescents born preterm had similar cognitive, motor, behavioral, and functional outcomes. Cognitive deficits were detected in 14.3% of adolescents born with a CHD and 11.8% of adolescents born preterm. Motor difficulties were detected in 43.5% of adolescents born with a CHD and 50% of adolescents born preterm. Behavioral problems were found in 23.7% of adolescents in the CHD group and 22.9% in the preterm group. Functional limitations were detected in 12% of adolescents born with a CHD and 7.3% of adolescents born preterm.

Conclusions

Adolescents born with a CHD or born preterm have similar profiles of developmental deficits. These findings highlight the importance of providing long-term surveillance to both populations and guide the provision of appropriate educational and rehabilitation services to better ameliorate long-term developmental difficulties.

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Keywords : premature, congenital heart defects, cognition, motor skills, behavior, functional limitations

Abbreviations : CHD, Leiter-R, MABC-II, MCH, SDQ, VABS-II

Plan

Methods

Results

Discussion

Supported by an operating grant from the Canadian Institutes of Health Research (MOP-102720). N.D-O., the doctoral student working on this project, received 2 studentships to support her work from the Montreal Children's Hospital Research Institute—Foundation of Stars (2009-2010) and the Fonds de recherche du Québec—Santé (2010-2013). This work was also supported by infrastructure from the Montreal Children's Hospital—Research Institute and Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, both of which are funded by the Fonds de recherche du Québec—Santé. The authors declare no conflicts of interest.