Neurodevelopmental outcomes at 2 and 4 years in children with congenital heart disease

Background and Objectives: Children with congenital heart disease (CHD) are at risk for neurodevelopmental (ND) delays. The purpose of this study is to compare the ND testing results of children with CHD at 2 and 4 years of age and determine if rates of ND delays change over time.
Methods: Children with CHD completed the Bayley Scales of Infant Development‐III (BSID‐III) at 2 years of age, and standardized neuropsychological measures at 4 years. Scores were compared with test norms and were classified as: average (within one SD of test mean); at risk (1‐2 SDs from the test mean); and delayed (>2 SD from test mean). Pearson correlations and McNemar’s exact tests were performed to deter‐mine the relationship between test scores at the two times of assessment.
Results: Sixty‐four patients completed evaluations at 24 ± 3 months of age and 4 years of age. BSID‐III cognitive and fine motor scores were correlated with pre‐school IQ and fine motor scores, r = .75 to .87, P < .0001. Agreement in score catego‐ries was 79% for cognitive and 61% for fine motor. More patients had at risk or delayed scores at age 4 vs age 2 (P≤.01).
Conclusion(s): Despite significant correlations between 2‐ and 4‐year‐old test scores, many patients who scored in the average range at age 2 showed deficits at age 4. BSID‐III scores at age 2 may underestimate delays. Therefore, longitudinal ND as‐sessment is recommended.