Calderon J, et al. - This trial incorporated the characterization and comparison of the cognitive outcomes in children with operated (open-heart surgery) and non-operated (catheter-based interventions only or no intervention) congenital heart defects (CHD). Researchers also sought to identify the related risk factors. A high proportion of preschool children with CHD with or without surgery were discovered to be at early cognitive risk, regardless of the mean scores within the normative range. Small for gestational age (SGA) was disclosed to be a strong predictor of the neurodevelopmental prognosis in CHD.

Methods

• The outcomes of 3-year-old children with CHD with or without open-heart surgery were reported in this research.
• This scheme of this trial was a prospective population-based study.
• The main outcome measures included the analysis of standardised cognitive scores (mean scores and proportions below normative values) with the Kaufman Assessment Battery for Children II.
• Furthermore, demographic, perinatal and operative variables as predictors of cognitive outcomes were examined.

Results

• The enrollees included 419 children (154 with open-heart surgery; 265 without surgery).
• No variation was noted in the global cognitive scores among the groups.
• In contrast with the non-operated group, children who underwent surgery obtained lower scores in expressive language (p=0.03) and logical reasoning (p=0.05).
• When compared with test norms, higher frequency of global cognitive scores >1 SDs below the expected mean was disclosed in the surgical group (25% vs 16% in the general population) (p=0.03).
• The findings illustrated that a higher-than-expected proportion of children in the non-operated group scored >2 SDs below the expected mean (7% vs 2%) (p=0.05).
• Being small for gestational age (SGA) substantially raised the risk of cognitive impairment in the surgical group, after adjustments for multiple covariates including maternal education, complexity of the CHD and operative-related variables (adjusted OR=5.9; 95% CI (1.7 to 20.1)).