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Comparison of motor outcomes between preschool children with univentricular and biventricular critical heart disease not diagnosed with cerebral palsy or acquired brain injury.

Authors
  • Ricci, M Florencia1
  • Fung, Alastair2
  • Moddemann, Diane1
  • Micek, Victoria3
  • Bond, Gwen Y3
  • Guerra, Gonzalo G4
  • Day, Chelsea1
  • Robertson, Charlene M T3, 5
  • 1 Child Development Clinic, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada. , (Canada)
  • 2 Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada. , (Canada)
  • 3 Complex Pediatric Therapies Follow-up Program, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada. , (Canada)
  • 4 Division of Pediatric Critical Care, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. , (Canada)
  • 5 Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. , (Canada)
Type
Published Article
Journal
Cardiology in the Young
Publisher
Cambridge University Press
Publication Date
Nov 01, 2021
Volume
31
Issue
11
Pages
1788–1795
Identifiers
DOI: 10.1017/S1047951121000895
PMID: 33685537
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This comparison study of two groups within an inception cohort aimed to compare the frequency of motor impairment between preschool children with univentricular and biventricular critical congenital heart disease (CHD) not diagnosed with cerebral palsy/acquired brain injury, describe and compare their motor profiles and explore predictors of motor impairment in each group.Children with an intellectual quotient <70 or cerebral palsy/acquired brain injury were excluded. Motor skills were assessed with the Movement Assessment Battery for Children-2. Total scores <5th percentile indicated motor impairment. Statistical analysis included χ2 test and multiple logistic regression analysis.At a mean age of 55.4 (standard deviation 3.77) months, motor impairment was present in 11.8% of those with biventricular critical CHD, and 32.4% (p < 0.001) of those with univentricular critical CHD. The greatest difference between children with biventricular and univentricular CHD was seen in total test scores 8.73(2.9) versus 6.44(2.8) (p < 0.01) and in balance skills, 8.84 (2.8) versus 6.97 (2.5) (p = 0.001). Manual dexterity mean scores of children with univentricular CHD were significantly below the general population mean (>than one standard deviation). Independent odds ratio for motor impairment in children with biventricular critical CHD was presence of chromosomal abnormality, odds ratio 10.9 (CI 2.13-55.8) (p = 0.004); and in children with univentricular critical CHD odds ratio were: postoperative day 1-5 highest lactate (mmol/L), OR: 1.65 (C1.04-2.62) (p = 0.034), and dialysis requirement any time before the 4.5-year-old assessment, OR: 7.8 (CI 1.08-56.5) (p = 0.042).Early assessment of motor skills, particularly balance and manual dexterity, allows for intervention and supports that can address challenges during the school years.

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