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Gross motor development is delayed following early cardiac surgery

Published online by Cambridge University Press:  29 February 2012

Suzanne H. Long ,
Susan R. Harris ,
Beverley J. Eldridge  and
Mary P. Galea
Suzanne H. Long*
Affiliation:
Heart Research, Critical Care & Neurosciences, Murdoch Children's Research Institute, Australia Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
Susan R. Harris
Affiliation:
Department of Physical Therapy, The University of British Columbia, Vancouver, Canada
Beverley J. Eldridge
Affiliation:
Physiotherapy Department, The Royal Children's Hospital, Melbourne, Australia
Mary P. Galea
Affiliation:
Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
*
Correspondence to: S. H. Long, PhD, Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, 1st Floor, 200 Berkeley Street, Carlton, Victoria 3010, Australia. Tel: +61 3 8344 4171; Fax: +61 3 8344 4188; E-mail: [email protected]
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Abstract

Objective

To describe the gross motor development of infants who had undergone cardiac surgery in the neonatal or early infant period.

Methods

Gross motor performance was assessed when infants were 4, 8, 12, and 16 months of age with the Alberta Infant Motor Scale. This scale is a discriminative gross motor outcome measure that may be used to assess infants from birth to independent walking. Infants were videotaped during the assessment and were later evaluated by a senior paediatric physiotherapist who was blinded to each infant's medical history, including previous clinical assessments. Demographic, diagnostic, surgical, critical care, and medical variables were considered with respect to gross motor outcomes.

Results

A total of 50 infants who underwent elective or emergency cardiac surgery at less than or up to 8 weeks of age, between July 2006 and January 2008, were recruited to this study and were assessed at 4 months of age. Approximately, 92%, 84%, and 94% of study participants returned for assessment at 8, 12, and 16 months of age, respectively. Study participants had delayed gross motor development across all study time points; 62% of study participants did not have typical gross motor development during the first year of life. Hospital length of stay was associated with gross motor outcome across infancy.

Conclusion

Active gross motor surveillance of all infants undergoing early cardiac surgery is recommended. Further studies of larger congenital heart disease samples are required, as are longitudinal studies that determine the significance of these findings at school age and beyond.

Keywords

Congenital heart diseaseAlberta Infant Motor Scaledevelopmental delay
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 5 , 13 September 2012 , pp. 574 - 582
Copyright
Copyright © Cambridge University Press 2012

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References

1.Ballweg, JA, Wernovsky, G, Gaynor, JW. Neurodevelopmental outcomes following congenital heart surgery. Pediatr Cardiol 2007; 28: 126–133.CrossRefGoogle ScholarPubMed
2.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: e818–e827.CrossRefGoogle ScholarPubMed
3.Darrah, J, Redfern, L, Maguire, TO, Beaulne, AP, Watt, J. Intra-individual stability of rate of gross motor development in full-term infants. Early Hum Dev 1998; 52: 169–179.CrossRefGoogle ScholarPubMed
4.Piper, M, Darrah, J. Motor assessment of the developing infant. WB Saunders, Philadelphia, 1994.Google Scholar
5.Rosenbaum, PL, Russell, DJ, Cadman, DT, Gowland, C, Jarvis, S, Hardy, S. Issues in measuring change in motor function in children with cerebral palsy: a special communication. Phys Ther 1990; 70: 125–131.CrossRefGoogle ScholarPubMed
6.Piper, MC, Pinnell, LE, Darrah, J, Maguire, T, Byrne, PJ. Construction and validation of the Alberta Infant Motor Scale (AIMS). Can J Public Health 1992; 83 (Suppl 2): S46–S50.Google ScholarPubMed
7.Majnemer, A, Snider, L. A comparison of developmental assessments of the newborn and young infant. Ment Retard Dev Disabil Res Rev 2005; 11: 68–73.CrossRefGoogle ScholarPubMed
8.Spittle, AJ, Doyle, LW, Boyd, RN. A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life. Dev Med Child Neurol 2008; 50: 254–266.CrossRefGoogle ScholarPubMed
9.Roberts, G, Howard, K, Spittle, AJ, Brown, NC, Anderson, PJ, Doyle, LW. Rates of early intervention services in very preterm children with developmental disabilities at age 2 years. J Paediatr Child Health 2008; 44: 276–280.CrossRefGoogle ScholarPubMed
10.Spittle, AJ, Treyvaud, K, Doyle, LW, et al. . Early emergence of behavior and social-emotional problems in very preterm infants. J Am Acad Child Adolesc Psychiatry 2009; 48: 909–918.CrossRefGoogle ScholarPubMed
11.Treyvaud, K, Anderson, VA, Howard, K, et al. . Parenting behavior is associated with the early neurobehavioral development of very preterm children. Pediatrics 2009; 123: 555–561.CrossRefGoogle ScholarPubMed
12.Bartlett, DJ. Comparison of 15-month motor and 18-month neurological outcomes of term infants with and without motor delays at 10-months-of-age. Phys Occup Ther Pediatr 2000; 19: 61–72.CrossRefGoogle Scholar
13.Van Haastert, IC, de Vries, LS, Helders, PJM, Jongmans, MJ. Early gross motor development of preterm infants according to the Alberta Infant Motor Scale. J Pediatr 2006; 149: 617–622.CrossRefGoogle Scholar
14.Sarajuuri, A, Lonnqvist, T, Mildh, L, et al. . Prospective follow-up study of children with univentricular heart: neurodevelopmental outcome at age 12 months. J Thorac Cardiovasc Surg 2009; 137: 139–145.CrossRefGoogle ScholarPubMed
15.Robertson, CM, Joffe, AR, Sauve, RS, et al. . Outcomes from an interprovincial program of newborn open heart surgery. J Pediatr 2004; 144: 86–92.CrossRefGoogle ScholarPubMed
16.Schultz, AH, Jarvik, GP, Wernovsky, G, et al. . Effect of congenital heart disease on neurodevelopmental outcomes within multiple-gestation births. J Thorac Cardiovasc Surg 2005; 130: 1511–1516.CrossRefGoogle ScholarPubMed
17.Limperopoulos, C, Majnemer, A, Shevell, MI, Rosenblatt, B, Rohlicek, C, Tchervenkov, C. Neurodevelopmental status of newborns and infants with congenital heart defects before and after open heart surgery. J Pediatr 2000; 137: 638–645.CrossRefGoogle ScholarPubMed
18.Bellinger, DC, Jonas, RA, Rappaport, LA, et al. . Developmental and neurologic status of children after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. N Engl J Med 1995; 332: 549–555.CrossRefGoogle ScholarPubMed
19.Gaynor, JW, Jarvik, GP, Bernbaum, J, et al. . The relationship of postoperative electrographic seizures to neurodevelopmental outcome at 1 year of age after neonatal and infant cardiac surgery. J Thorac Cardiovasc Surg 2006; 131: 181–189.CrossRefGoogle ScholarPubMed
20.Gaynor, JW, Wernovsky, G, Jarvik, GP, et al. . Patient characteristics are important determinants of neurodevelopmental outcome at one year of age after neonatal and infant cardiac surgery. J Thorac Cardiovasc Surg 2007; 133: 1344–1353.CrossRefGoogle ScholarPubMed
21.Alton, GY, Robertson, CMT, Sauve, R, et al. . Early childhood health, growth, and neurodevelopmental outcomes after complete repair of total anomalous pulmonary venous connection at 6 weeks or younger. J Thorac Cardiovasc Surg 2007; 133: 905–911.CrossRefGoogle ScholarPubMed
22.Visconti, KJ, Rimmer, D, Gauvreau, K, et al. . Regional low-flow perfusion versus circulatory arrest in neonates: one-year neurodevelopmental outcome. Ann Thorac Surg 2006; 82: 2207–2213.CrossRefGoogle ScholarPubMed
23.Atallah, J, Dinu, IA, Joffe, AR, et al. . Two-year survival and mental and psychomotor outcomes after the Norwood procedure: an analysis of the modified Blalock–Taussig shunt and right ventricle-to-pulmonary artery shunt surgical eras. Circulation 2008; 118: 1410–1418.CrossRefGoogle ScholarPubMed
24.Gaynor, JW, Gerdes, M, Zackai, EH, et al. . Apolipoprotein E genotype and neurodevelopmental sequelae of infant cardiac surgery. J Thorac Cardiovasc Surg 2003; 126: 1736–1745.CrossRefGoogle ScholarPubMed
25.Creighton, DE, Robertson, CMT, Sauve, RS, et al. . Neurocognitive, functional, and health outcomes at 5 years of age for children after complex cardiac surgery at 6 weeks of age or younger. Pediatrics 2007; 120: e478–e486.CrossRefGoogle ScholarPubMed
26.Wells, FC, Coghill, S, Caplan, HL, Lincoln, C. Duration of circulatory arrest does influence the psychological development of children after cardiac operation in early life. J Thorac Cardiovasc Surg 1983; 86: 823–831.CrossRefGoogle ScholarPubMed
27.Oates, RK, Simpson, JM, Turnbull, JA, Cartmill, TB. The relationship between intelligence and duration of circulatory arrest with deep hypothermia. J Thorac Cardiovasc Surg 1995; 110: 786–792.CrossRefGoogle ScholarPubMed
28.Bellinger, DC, Wypij, D, Kuban, KC, et al. . Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation 1999; 100: 526–532.CrossRefGoogle ScholarPubMed
29.McQuillen, P, Barkovich, A, Hamrick, S, et al. . Temporal and anatomic risk profile of brain injury with neonatal repair of congenital heart defects. Stroke 2007; 38: 736–741.CrossRefGoogle ScholarPubMed
30.Beca, J, Gunn, J, Coleman, L, et al. . Pre-operative brain injury in newborn infants with transposition of the great arteries occurs at rates similar to other complex congenital heart disease and is not related to balloon atrial septostomy. J Am Coll Cardiol 2009; 53: 1807–1811.CrossRefGoogle Scholar
31.Limperopoulos, C, Majnemer, A, Shevell, MI, et al. . Predictors of developmental disabilities after open heart surgery in young children with congenital heart defects. J Pediatr 2002; 141: 51–58.CrossRefGoogle ScholarPubMed
32.Newburger, JW, Wypij, D, Bellinger, DC, et al. . Length of stay after infant heart surgery is related to cognitive outcome at age 8 years. J Pediatr 2003; 143: 67–73.CrossRefGoogle ScholarPubMed
33.Long, SH, Galea, MP, Eldridge, BJ, Harris, SR. Risk factors for gross motor dysfunction in infants with congenital heart disease. Infants Young Child 2011; 24: 246–258.CrossRefGoogle Scholar
34.Darrah, J, Piper, M, Watt, M. Assessment of gross motor skills of at-risk infants: predictive validity of the Alberta Infant Motor Scale. Dev Med Child Neurol 1998; 40: 485–491.CrossRefGoogle ScholarPubMed
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