Developmental outcomes after early surgery for complex congenital heart disease: a systematic review and meta-analysis

Darlene Huisenga, Sacha La Bastide-Van Gemert, Andrew Van Bergen, Jane Sweeney, Mijna Hadders-Algra*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

51 Citations (Scopus)
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AIM: (1) To systematically review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease (CHD) who underwent early surgery; (2) to run a meta-regression analysis on the Bayley Scales of Infant Development, Second Edition Mental Developmental Index and Psychomotor Developmental Index (PDI) of infants up to 24 months and IQs of preschool-aged children to adolescents; (3) to assess associations between perioperative risk factors and outcomes.

METHOD: We searched pertinent literature (January 1990 to January 2019) in PubMed, Embase, CINAHL, and PsycINFO. Selection criteria included infants with complex CHD who had primary surgery within the first 9 weeks of life. Methodological quality, including risk of bias and internal validity, were assessed.

RESULTS: In total, 185 papers met the inclusion criteria; the 100 with high to moderate methodological quality were analysed in detail. Substantial heterogeneity in the group with CHD and in methodology existed. The outcome of infants with single-ventricle CHD was inferior to those with two-ventricle CHD (respectively: average scores for PDI 77 and 88; intelligence scores 92 and 98). Perioperative risk factors were inconsistently associated with developmental outcomes.

INTERPRETATION: The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes.

WHAT THIS PAPER ADDS: Children with complex congenital heart disease (CHD) are at increased risk of impaired developmental outcome. Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD. Children with two-ventricle CHD gradually grow out of their initial developmental impairment. Perioperative factors are inconsistently associated with outcome.

Original languageEnglish
Pages (from-to)29-46
Number of pages18
JournalDevelopmental Medicine and Child Neurology
Issue number1
Early online date9-Mar-2020
Publication statusPublished - Jan-2021

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