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Neuromotor performance in infants before and after early open-heart surgery and risk factors for delayed development at 6 months of age

Published online by Cambridge University Press:  24 October 2018

Miranda J. Campbell ,
Jenny M. Ziviani ,
Christian F. Stocker ,
Asaduzzaman Khan  and
Leanne Sakzewski
Miranda J. Campbell*
Affiliation:
Children’s Health Queensland, Brisbane, Queensland, Australia School of Health and Rehabilitation Science, The University of Queensland, Brisbane, Queensland, Australia
Jenny M. Ziviani
Affiliation:
School of Health and Rehabilitation Science, The University of Queensland, Brisbane, Queensland, Australia
Christian F. Stocker
Affiliation:
Children’s Health Queensland, Brisbane, Queensland, Australia
Asaduzzaman Khan
Affiliation:
School of Health and Rehabilitation Science, The University of Queensland, Brisbane, Queensland, Australia
Leanne Sakzewski
Affiliation:
Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
*
Author for correspondence: M. J. Campbell, Occupational and Music Therapy Department, Level 7 Lady Cilento Children’s Hospital, 501 Stanley Street, South Brisbane, QLD 4101, Australia. Tel: +617 3068 1111; E-mail: miranda.campbell@health.qld.gov.au
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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.

Keywords

Cardiac surgeryneurodevelopmentdevelopmental surveillanceCHDother
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 2 , February 2019 , pp. 100 - 109
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Campbell MJ, Ziviani JM, Stocker CF, Khan A, Sakzewski L. (2018) Neuromotor performance in infants before and after early open-heart surgery and risk factors for delayed development at 6 months of age. Cardiology in the Young page 100 of 109. doi: 10.1017/S1047951118001622

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