Cognitive and behavioral outcome in Dutch children after neonatal surgery for congenital heart disease

Abstract

More and more children with a congenital heart disease [CHD] survive, as diagnosis and surgical possibilities improve. Along with these improvements, interests in longer-term cognitive and behavioral outcomes of these children increase. The aim of the present study was to map the cognitive and behavioral development of children with a coarctation or interruption of the aortic arch with or without hypoplastic left heart syndrome. This longitudinal follow-up study used participants from an earlier RCT and examined cognition with the Bayley-III-NL at age 24 months (n = 32), and the WPPSI-III-NL at age five years (n = 22). Behavior was examined with the CBCL/1.5-5 at both 24 months and five years and with the C-TRF at five years. Results showed that the cognition of CHD children was in the normal range at both 24 months and five years, but that their processing speed was significantly lower. According to their parents (at both 24 months and five years) and teachers, the CHD children show less anxious/depressed behavior then their typically developing peers. Teachers report higher attention problem scores in these children. Bayley-III-NL cognition score was a significant predictor of WPPSI-III-NL FSIQ score. More attention problems according to parents at age five predict more attention problems according to teachers at age five. Higher attention problem scores reported by teachers at age five predict a lower FSIQ score at age five. It can be concluded that the behavioral and cognitive outcome in this sample is relatively positive. It is important to closely monitor the attention problems in CHD children, as they seem to affect cognitive development.