Perioperative Brain Injury in Relation to Early Neurodevelopment among Children with Severe Congenital Heart Disease: Results from a European Collaboration
Year: 2024
Type: article
Study design: Observational Study
Abstract: Objective: To examine the relationship between perioperative brain injury and neurodevelopment during early childhood in patients with severe congenital heart disease (CHD). Study design: One hundred and seventy children with CHD and born at term who required cardiopulmonary bypass surgery in the first 6 weeks after birth were recruited from 3 European centers and underwent preoperative and postoperative brain MRIs. Uniform description of imaging findings was performed and an overall brain injury score was created, based on the sum of the worst preoperative or postoperative brain injury subscores. Motor and cognitive outcomes were assessed with the Bayley Scales of Infant and Toddler Development Third Edition at 12 to 30 months of age. The relationship between brain injury score and clinical outcome was assessed using multiple linear regression analysis, adjusting for CHD severity, length of hospital stay (LOS), socioeconomic status (SES), and age at follow-up. Results: Neither the overall brain injury score nor any of the brain injury subscores correlated with motor or cognitive outcome. The number of preoperative white matter lesions was significantly associated with gross motor outcome after correction for multiple testing (P = .013, β = −0.50). SES was independently associated with cognitive outcome (P < .001, β = 0.26), and LOS with motor outcome (P < .001, β = −0.35). Conclusion: Preoperative white matter lesions appear to be the most predictive MRI marker for adverse early childhood gross motor outcome in this large European cohort of infants with severe CHD. LOS as a marker of disease severity, and SES influence outcome and future intervention trials need to address these risk factors.
Authors: European Association Brain in Congenital Heart Disease (EU-ABC) consortium, Arts-assistenten Kinderen, Brain, MS Neonatologie, Intensive care patientenzorg, Child Health, Regenerative Medicine and Stem Cells, Cardiologie onderzoek 1, Circulatory Health, Cardiopulmonale Chirurgie pat. zorg, MS Verloskunde, Kinderbewegingszorg patientenzorg, Psychosociale zorg patientenzorg, Other research (not in main researchprogram)
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W6995743315