The quality of general movements in infants with complex congenital heart disease undergoing surgery in the neonatal period
Recommended Citation
Huisenga DC, Van Bergen AH, Sweeney JK, Wu Y-C, Hadders-Algra M. The quality of general movements in infants with complex congenital heart disease undergoing surgery in the neonatal period. Early Hum Dev. 2020;151:105167. doi:10.1016/j.earlhumdev.2020.105167
Abstract
BACKGROUND: Advances in diagnostic technologies, surgical management, and perioperative care have increased survival for neonates with complex congenital heart disease (CCHD). The success of these advances exposed a heightened risk of brain injury and developmental disabilities. The General Movements Assessment, a non-invasive method, may detect early neurodevelopmental impairments in high-risk infants.
AIMS: To examine whether infants with CCHD undergoing neonatal surgery have higher prevalence of atypical general movements (GMs) than a reference group, and whether single ventricle physiology with systemic oxygen saturations
METHODS: Serial General Movements Assessment (GMA) in a cohort of infants with CCHD (n = 74) at writhing (term-6 weeks) and fidgety (7-17 weeks) GM-age. GMA focused on the presence of definitely abnormal GM-complexity and absent fidgety movements. Single GMAs at 3 months were available from a reference sample of Dutch infants (n = 300). Regression analyses examined relationships between cardiac characteristics and definitely abnormal GM-complexity.
RESULTS: Higher prevalence of definitely abnormal GM-complexity in infants with CCHD compared to reference infants (adjusted OR 5.938, 95% CI 2.423-14.355), single ventricle CCHD increased the risk. Occurrence of absent fidgety movements was similar in infants with CCHD and reference infants (adjusted OR 0.475, 95% CI 0.058-3.876). Systemic postoperative oxygen saturations
CONCLUSIONS: Infants with CCHD, especially those with single ventricle CCHD, are at increased risk of definitely abnormal GM-complexity. GMA at fidgety age is recommended.
Document Type
Article
PubMed ID
32916592
Affiliations
Advocate Children's Hospital, Department of Pediatric Rehabilitation and Development
Advocate Children's Hospital, Advocate Children's Heart Institute, Division of Pediatric Cardiac Critical Care