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Utilisation of early intervention services in infants with congenital heart disease following open-heart surgery

Published online by Cambridge University Press:  30 December 2020

Caroline West*
Affiliation:
Department of Pediatrics, University of Michigan Mott Children’s Hospital, Ann Arbor, MI, USA
Sunkyung Yu
Affiliation:
Department of Pediatrics, University of Michigan Mott Children’s Hospital, Ann Arbor, MI, USA
Ray Lowery
Affiliation:
Department of Pediatrics, University of Michigan Mott Children’s Hospital, Ann Arbor, MI, USA
Caren S. Goldberg
Affiliation:
Department of Pediatrics, University of Michigan Mott Children’s Hospital, Ann Arbor, MI, USA
Karen Uzark
Affiliation:
Department of Pediatrics, University of Michigan Mott Children’s Hospital, Ann Arbor, MI, USA
*
Author for correspondence: Dr C. West, MD, MS, University of Michigan Mott Children’s Hospital, 1540 East Hospital Drive, C&W 11-715, SPC 4204, Ann Arbor, MI48104, USA. Tel: +1 412-498-3845; Fax: 1-734-936-9470. E-mail: [email protected]

Abstract

Objective:

To examine the use of early intervention services in infants with CHD after open-heart surgery and identify factors associated with receipt of services.

Study design:

Surveys were administered to caregivers of infants who underwent open-heart surgery before 1 year of age at a single institution between July, 2017 and July, 2018. Information regarding the infant’s use of early intervention services and the caregiver’s experience with the programme was obtained. Clinical data were retrieved from the medical record review. Logistic regression identified factors associated with receipt of services.

Results:

The study included 158 eligible infants. Ninety-eight caregivers (62%) completed the surveys. Of those surveyed, 53.1% of infants were currently or previously enrolled in early intervention services. Infants most frequently received physical therapy (76.9%). The majority of caregivers found services to be moderately/very helpful (92.3%) and sufficient for their child (76.9%). In the univariate analysis, single-ventricle disease, known syndrome/genetic abnormality, extracardiac anomaly, and longer intensive care and hospital length of stay were associated with receipt of services. Single-ventricle disease (p = 0.004) and known syndrome/genetic abnormality (p < 0.0001) remained independently associated with receipt of services in the multivariable analysis.

Conclusion:

Amongst infants at risk for neurodevelopmental deficits, approximately half received services after open-heart surgery. Caregivers expressed satisfaction with the programme. While infants with single-ventricle disease and a known syndrome/genetic abnormality were more likely to receive early intervention services, many at-risk infants with CHD failed to receive services. Further research is needed to identify barriers to early intervention services and promote developmental outcomes.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

Presented at the 8th Annual Scientific Sessions of the Cardiac Neurodevelopmental Outcomes Collaborative, Toronto, Ontario, 2019, Canada.

References

Mussatto, KA, Hoffmann, RG, Hoffman, GM, et al. Risk and prevalence of developmental delay in young children with congenital heart disease. Pediatrics 2014; 133: e570e577.10.1542/peds.2013-2309CrossRefGoogle ScholarPubMed
Sananes, R, Manlhiot, C, Kelly, E, et al. Neurodevelopmental outcomes after open heart operations before 3 months of age. Ann Thorac Surg 2012; 93: 15771583.10.1016/j.athoracsur.2012.02.011CrossRefGoogle ScholarPubMed
Snookes, SH, Gunn, JK, Eldridge, BJ, et al. A systematic review of motor and cognitive outcomes after early surgery for congenital heart disease. Pediatrics 2010; 125: e818e827.10.1542/peds.2009-1959CrossRefGoogle ScholarPubMed
Marino, BS, Lipkin, PH, Newburger, JW, et al. Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American heart association. Circulation 2012; 126: 11431172.10.1161/CIR.0b013e318265ee8aCrossRefGoogle ScholarPubMed
Center for Disease Control. What is “Early intervention”? Learn signs act early. 2019. www.cdc.gov/ncbddd/actearly/parents/states.html.Google Scholar
Loccoh, EC, Yu, S, Donohue, J, et al. Prevalence and risk factors associated with non-attendance in neurodevelopmental follow-up clinic among infants with CHD. Cardiol Young 2018; 28: 554560.10.1017/S1047951117002748CrossRefGoogle ScholarPubMed
Roberts, G, Howard, K, Spittle, AJ, et al. Rates of early intervention services in very preterm children with developmental disabilities at age 2 years. J Paediatr Child Health 2008; 44: 276280.10.1111/j.1440-1754.2007.01251.xCrossRefGoogle ScholarPubMed
Mussatto, KA, Hollenbeck-Pringle, D, Trachtenberg, F, et al. Utilisation of early intervention services in young children with hypoplastic left heart syndrome. Cardiol Young 2018; 28: 126133.10.1017/S104795111700169XCrossRefGoogle ScholarPubMed
Newburger, JW, Sleeper, LA, Bellinger, DC, et al. Early developmental outcome in children with hypoplastic left heart syndrome and related anomalies: the single ventricle reconstruction trial. Circulation 2012; 125: 20812091.10.1161/CIRCULATIONAHA.111.064113CrossRefGoogle ScholarPubMed
Tabbutt, S, Nord, AS, Jarvik, GP, et al. Neurodevelopmental outcomes after staged palliation for hypoplastic left heart syndrome. Pediatrics 2008; 121: 476483.10.1542/peds.2007-1282CrossRefGoogle ScholarPubMed
Lipkin, PH, Macias, MM, Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Promoting optimal development: identifying infants and young children with developmental disorders through developmental surveillance and screening. Pediatrics 2020; 145: e20193449.10.1542/peds.2019-3449CrossRefGoogle ScholarPubMed
Knutson, S, Kelleman, MS, Kochilas, L. Implementation of developmental screening guidelines for children with congenital heart disease. J Pediatr 2016; 176: 135e2141.e2.10.1016/j.jpeds.2016.05.029CrossRefGoogle ScholarPubMed