Neurodevelopmental Outcomes for Babies with Congenital Heart Defects Are Better with Delivery at 39 Weeks or More
PHILADELPHIA, May 11, 2011 /PRNewswire-USNewswire/ -- Children with congenital heart defects (CHD) who undergo heart surgery in infancy have better neurodevelopmental outcomes at age four if they were born closer to term (39 or 40 weeks gestational age). Researchers from the Cardiac Center at The Children's Hospital of Philadelphia found better outcomes in infants born at greater than 39 weeks compared to infants born at 36 to 38 weeks.
Early delivery of a child with CHD is sometimes necessary because of concerns over maternal or fetal health. This research suggests that, in the absence of such concerns, elective or spontaneous delivery at 39-40 weeks is associated with better neurodevelopmental outcomes. This study has important implications for management of fetuses in whom a diagnosis of CHD is made before birth.
The study team presented their results at the annual meeting of the American Association for Thoracic Surgery in Philadelphia.
"Previous research has suggested that gestational age less than 39 weeks, even at 36-38 weeks, has been associated with increased mortality and morbidity in patients with CHD," said Donna A. Goff, M.D., M.S., a cardiologist at The Children's Hospital of Philadelphia. "Ours was the first study to look closely at neurodevelopmental outcomes in late pre-term infants who had cardiac surgery during infancy."
The researchers analyzed 351 infants who were born at 36 weeks gestation or later that were enrolled in a study for apolipoprotein-E (APOE) polymorphisms and neurodevelopmental outcome after infant cardiac surgery. Formal neurodevelopmental testing was performed at four years of age. Tests included cognition, language skills, attention, impulsivity, memory, executive function, social competence and visual-motor and fine-motor skills.
The median gestational age was 39 weeks with 125 patients born at 40 weeks or older. Older gestational age predicted better performance for short and long-term outcomes including cognition, visual-motor and fine-motor skills.
The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 516-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.
Contact: Joey McCool Ryan(267) 426-6070McCool@email.chop.edu
SOURCE The Children's Hospital of Philadelphia