Children with CHD or born very preterm are at risk for brain dysmaturation and poor neurodevelopmental outcomes. Yet, studies have primarily investigated the neurodevelopmental outcomes of these groups separately. The objective of this study is to compare neurodevelopmental outcomes and parent behavior ratings of children born term with CHD to children born very preterm.Roberts SD, Sananes R, Wojtowicz M, Seed M, Miller SP, Chau V, Au-Young SH, Guo T, Ly L, Kazazian V, Grunau RE, and Williams TS (2024). Neurodevelopmental outcomes at 18 months of children diagnosed with CHD compared to children born very preterm. Cardiology in the Young, page 1 of 7. doi: 10.1017/ S1047951123004316
Objective 2: examine associations with sociodemographic and white matter injury characteristics The Bayley-III cognitive composite was positively associated with English as a primary language and household median income, and the language composite score on the Bayley-III was positively associated with English as a primary language. The total problem Child Behaviour Checklist composite score was associated with median income. The regression model examining cognitive composite scores was significant (F(6,136) = 3.30, p = 0.005, R = 0.364) explaining 13.2% of the variance. English as the childs primary language ( =0.253, p = 0.004) was associated with higher cognitive composite scores. Higher median income approached significance Published online by Cambridge University Press
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Cardiology in the Young in the model ( =0.171, p = 0.055) as a predictor of higher cognitive composite scores. The model examining language composite scores was significant (F(6,129) = 4.82, p < 0.001, R = 0.436), explaining 19% of the variance. English as a primary language ( =0.389, p < 0.001) was associated with higher language composite scores. Biological sex approached significance in the model ( =0.149, p = 0.079), with female sex associated with higher language composite scores. The model examining motor composite scores was not significant (F(6,130) = 0.79, p = 0.58, R = 0.192), explaining 3.7% of the variance. White matter injury volume approached significance in the model ( = 0.160, p = 0.085).
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The model examining the Child Behaviour Checklist total problem score was significant (F(6,137) = 3.27, p = 0.005, R = 0.361), explaining 13% of the variance. Median income (= 0.195, p = 0.029) and English as a primary language ( = 0.198, p = 0.024) were negatively associated with total problems. Specifically, lower median income and English as a second language were associated with higher total problem scores. Maternal age at birth approached significance ( = 0.165, p = 0.056), with lower maternal age at birth associated with higher total problems.
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Discussion The current study is one of few investigations comparing neurodevelopmental and behavioural outcomes in children with CHD and children born very preterm. Overall, this study documented many common early cognitive and behavioural outcomes among the two groups of children at 18 months of age. Two unique outcomes also emerged, with children in the CHD group having lower motor and expressive language scores and a greater proportion of children with impaired scores compared to very preterm children. While it is important not to minimise neurodevelopmental risk among these populations exemplified by the proportion of children with impaired scores, it is also important to acknowledge that group mean scores were broadly average (low average to average) for both groups at 18 months. This reflects the combined advancements in acute medical treatments and follow-up early intervention services and their associated positive impact on neurocognitive outcomes.2,44
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