Prenatal maternal mental health and social determinants of health may influence pregnancy, child hospitalisation, and child neurodevelopmental outcomes in critical congential heart disease (CHD). We examined 189 mother–child dyads of children born with CHD who underwent neonatal cardiac surgery and completed neurodevelopmental assessment between the ages 13 and 29 months. We used latent profile analysis to identify distinct maternal groups based on prenatal maternal mental health screening scores and individual- and neighbourhood-level social determinants of health factors. We examined the association between maternal groups with their child’s gestational age, birth weight, hospital length of stay (HLOS), and neurodevelopment. Latent profile analysis identified two distinct groups: high-risk (n = 46) and low-risk (n = 143). Mothers in the high-risk group had higher mental health screening scores, lower age, higher social vulnerability, lower education, and were more likely to have Medicaid insurance and represent a minority group than mothers in the low-risk group. The high-risk group had children with lower gestational age and weight at birth, longer HLOS, and lower cognitive, language, and motor scales than children in the low-risk group (p < 0.05). Sensitivity analysis in mother–infant dyads without foetal extracardiac conditions found that significant relationships persisted in the high-risk group, with lower gestational age and lower language scale scores than the low-risk group (p < 0.05). Children of mothers with adverse prenatal maternal mental health and social determinants of health risks had significantly worse pregnancy and child outcomes. Interventions are critically needed to address maternal mental health and social determinants of health risks beginning in the prenatal period.

Infants and children born with CHD are at significant risk for neurodevelopmental delays and abnormalities. Individualised developmental care is widely recognised as best practice to support early neurodevelopment for medically fragile infants born premature or requiring surgical intervention after birth. However, wide variability in clinical practice is consistently demonstrated in units caring for infants with CHD. The Cardiac Newborn Neuroprotective Network, a Special Interest Group of the Cardiac Neurodevelopmental Outcome Collaborative, formed a working group of experts to create an evidence-based developmental care pathway to guide clinical practice in hospital settings caring for infants with CHD. The clinical pathway, “Developmental Care Pathway for Hospitalized Infants with Congenital Heart Disease,” includes recommendations for standardised developmental assessment, parent mental health screening, and the implementation of a daily developmental care bundle, which incorporates individualised assessments and interventions tailored to meet the needs of this unique infant population and their families. Hospitals caring for infants with CHD are encouraged to adopt this developmental care pathway and track metrics and outcomes using a quality improvement framework.

Parental stress is a universal experience for parents who have children diagnosed with CHD and has been studied within the context of the child’s illness, but not through a broader health disparity lens. This paper provides a thorough synthesis of the current literature on parental stress addressing disparities in parents of children with CHD. Several theories and models from within this literature are described and a new comprehensive framework, the Parental Stress and Resilience in CHD Model, is presented. Future research and clinical implications are discussed.