The Study On The Developmental And Intellectual Status Of Infants With Congenital Heart Disease

Objective:1.To detect the development and the intelligence of infants with congenital heart disease.2.To indentify the influencing factors of developmental and mental retardation of infants with congenital heart disease.Methods:1.Infants with congenital heart disease who admitted to the Department of Cardiothoracic Surgery in Nanjing children’s hospital from August2010to August2011are taked as the object of the research.2. Detailed anthropometry was performed in354consecutive infants with congenital heart disease and z-scores were calculated. Developmental retardation was defined as weight, height and weight/height z-score<-2. The mental developmental status of125consecutive infants with congenital heart disease were evaluated by Bayley Scales of Infant Development(BSID).Mental retardation was defined as MDI<79, psychomotor retardation was defined as PDI<79.3. Questionnaires were answered by the parents of the cases.The content includes parental occupation and level of education、pregnancy、maternal childbearing age、birth status、 education and feeding,etc.4.The data was dealt with univariate analysis and logistic regression analysis using SPSS version13.0.Results:1.Developmental evaluation:354consecutive patients were included. Predictors of malnutrition at presentation are as summarized:weight z-score<-2(30.5%):lower birth weight (OR=3.844, P=0.001), pulmonary hypertention (OR=5.702, P=0.000), pneumonia (OR=2.161, P=0.005); height z-score<-2(17.5%):lower birth weight (OR=4.137, P=0.000), pulmonary hypertention(OR=2.352, P=0.047), pneumonia(OR=3.417, P=0.000); and weight/height z-score<-2(26.8%):pulmonary hypertention (OR=2.747, P=0.001)2.Mental evaluation:125consecutive patients were included.44(35.2%) infants had mental retardation,69(55.2%) infants had psychomotor retardation.Predictors of developmental retardation at presentation are as summarized:MDI<79:cyanosis (OR=3.462,95%CI=1.438-8.334);PDI<79:low birth weight(OR=6.836,95%CI=1.438-32.497);cyanosis(OR=2.498,95%CI=1.008-6.189).Conclusions:1.Developmental retardation is common in infants with CHD. Lower birth weight, pulmonary hypertention, pneumonia can affect significantly the developmental status of infants with CHD at presentation.2.Mental retardation is common in infants with CHD. Cyanosis is an extremely important factor that influence the mental status of these infants at presentation.