Occurrence and predictors of developmental impairments in 3-year-old children with congenital heart defects.
Occurrence and predictors of developmental impairments in 3-year-old children with congenital heart defects.
复制标题
3 岁先天性心脏病儿童发育障碍的发生及其预测因素。
DOI：
10.1097/dbp.0b013e318222eb5a
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
Vollrath,MargareteE
中科院分区：
文献类型：
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作者：
Brandlistuen,RagnhildEek;Stene-Larsen,Kim;Holmstrom,Henrik;Landolt,MarkusA;Eskedal,LeifT;Vollrath,MargareteE
目的：探讨不同严重程度的先天性心脏病（CHD）的3岁儿童的发育障碍的发生，并确定与严重CHD. Methods儿童发育障碍的预测因素：前瞻性数据收集在出生时，6，18，和36个月的挪威母亲和儿童队列研究（MoBa），由挪威公共卫生研究所进行的，与全国范围内的医疗CHD登记，并确定了175个3岁的CHD在一个队列的44,044名儿童。轻度/中度（n = 115）和重度（n = 60）CHD儿童与非CHD儿童（43，929）在运动、沟通和社会障碍方面进行了比较，这些障碍由挪威母亲和儿童队列研究问卷中的母亲报告。分析了重度CHD组发育障碍的预测因素。结果：重度CHD儿童的沟通和粗大运动障碍的几率是对照组的3倍以上，任何发育障碍的几率是对照组的2倍。轻度和中度CHD儿童的粗大运动障碍几率高2倍以上，但与对照组无差异。确定的损害的预测因素是以前的发育障碍和较小的头围在birth.Conclusion：严重冠心病儿童在3岁时的发育障碍的几率增加。早期发育障碍与后期发育障碍有关，这表明是持久的障碍，而不仅仅是暂时的延迟。应考虑患者出生时的具体情况，并提供运动和沟通支持，以潜在地改善CHD儿童的结局。
Objective:To examine the occurrence of developmental impairments in 3-year-old children with varying severity of congenital heart defects (CHD) and to identify predictors associated with developmental impairment in children with severe CHD.Methods:Prospective data collected at birth, 6, 18, and 36 months from the Norwegian Mother and Child Cohort Study (MoBa), conducted by the Norwegian Institute of Public Health, were linked with a nationwide medical CHD registry, and 175 three year olds with CHD in a cohort of 44,044 children were identified. Children with mild/moderate (n= 115) and severe (n= 60) CHD were compared with children without CHD (43,929) on motor, communication, and social impairments as reported by mothers in Norwegian Mother and Child Cohort Study questionnaires. Predictors of developmental impairment were analyzed for the group with severe CHD.Results:Children with severe CHD had> 3 times higher odds of communication and gross motor impairments compared with controls, and had 2 times higher odds of any developmental impairment compared with controls. Children with mild and moderate CHD had> 2 times higher odds of gross motor impairment but did not otherwise differ from controls. Predictors of impairment identified were previous developmental impairments and smaller head circumference at birth.Conclusion:Children with severe CHD have increased odds of developmental impairments at age 3 years. Early developmental impairments are associated with later developmental impairments, suggesting lasting impairments and not merely temporary delay. Patient-specific conditions at birth should be considered and motor and communication support provided to potentially improve outcomes in children with CHD.