| Background Congenital heart defects(CHD) are one of the most common birth defects globally,and70~80% is the acyanotic CHD, which is very common category. Since advances in medical and surgical care have significantly contributed to an important increase in the survival rates of children with CHD over the past several decades. However,survivors often have problems in growth development, such as neurodevelopmental and behavioral impairment and cognitive disorders, which affect their quality of life.In contrast, studies of children with CHD have been few and of limited scope in China.This study therefore have been undertook for evaluate the growth development in children with acyanotic CHD regarding to the motor development, language comprehensive ability, bone strength, and to early identify the children with developmental delays, providing the essential clinical basis for obtaining appropriate and optimal rehabilitation intervention to maximize these children’s potential overall development, to improve their life of quality, as well as their family.Methods Children aged with 2 to 6 years with various of acyanotic CHD were examined for growth development and compared with healthy kindergarten children in the same age range, including the motor function, bone strength, speech. One hundred children with acyanotic CHD(acyanotic CHD group), 43 boys, 57 girls, aged 47.17±10.65 months, and one hundred healthy children,52 boys, 48 girls, aged 49.89±11.06 months,were evaluated using the Peabody Developmental Motor Scale-2, Fine Motor Quotient(FMQ) and Gross Motor Quotient(GMQ) were regarded as the main outcomes of Motor function, and for the bone strength assessment, the ultrasound bone strength measurement was applied into the two groups, the Sound Of Speed(SOS), Z-score, percentile in bone was the outcome index. 30 children with acyanotic CHD, 14 boys, 16 girls, aged 41.10±4.37 months, and 30 healthy children, 14 boys,16 girls, aged 41.10±4.51 months from the two groups was recruited and assessed by Vocabulary Comprehension Test of Children(VCTC), compared the difference in VCTC scores between both group. Comparisons between means were made in SPSS statistical software(version20.0). The significance level was set to 0.05.Reaults1. The percent of lower than moderate level of FMQ and GMQ in acyanotic CHD group were 9%, 37%, and 1%, 12% in control group, relatively. Significantly differences were found in the percent of lower than moderate level of FMQ and GMQ in two groups(p=0.01; p<0.01).The mean scores of FMQ and GMQ in acyanotic CHD groups(mean/standard deviation,103.17±10.24,92.03±7.96) were lower than the control(105.28±7.91, 97.25±6.19), while only the GMQ showed a significant difference(p < 0.01). Future analyzed for the three sub-tests of gross function:Stationary, Locomotion and Object Manipulation, it showed significant differences in standard scores of these three sub-tests in both groups(p<0.01; p<0.01; p<0.01).The boys in two groups had difference in FMQ and GMQ(p=0.03; p<0.01), but only GMQ was showed difference in the girls of two group(p<0.01). For inter-analysis in acyanotic CHD group, FMQ of the girl patients was higher than the boys(p=0.02), but it wasn’t found in GMQ(p=0.38); there was no difference of FMQ and GMQ in diagnostic category(p=0.65; p=0.92).2. 20% of children with acyanotic CHD and 3% of the control had word comprehensive development delayed, which showed a difference(p=0.04). The scores of VCTC in two groups were 74.61±18.01, 82.85±10.61. The VCTC score in acyanotic CHD groups was significantly different from the control(p=0.04). There was no difference in boys’ scores between two groups(p=0.74), but the girls’ showed(p=0.02).For inter-analysis, there were no difference in gender and diagnostic category in children with acyanotic CHD(p=0.13; p=0.17).3. The SOS, Z-score, percentile of acyanotic CHD group were 3488.91±174.545m/s,-0.18±1.38、47.98±33.60%, and the control was 3520.82±127.27m/s,-0.31±1.18,42.41±30.80.%,relatively. There were no significant difference between two groups in SOS,Z-score, percentile(p=0.14, p=0.48, p=0.22). No SOS,Z-score, percentile difference were showed in boys comparison of two groups(p=0.87, p=0.17,p=0.12),yet in girls comparison(p=0.12、p=0.85、p=0.82). For inter-analysis of acyanotic CHD groups, there were no differences to be found in the gender(p=0.09, p=0.20,p=0.55)and diagnostic category((p=0.54, p=0.94, p=0.90).Conclusion The findings indicate Children with acyanotic CHD have a similar fine function with the health children, but a delay in gross function, which show in poor stationary and locomotion, as well as Object Manipulation. There is a trend of language comprehensive ability delay in children with acyanotic CHD. The bone strength status of children with acyanotic CHD and the healthy may occur alike. |
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