Community Based Pre-School Screening to Detect Developmental, Behavioural, Hearing and Vision Problems in Survivors of Neonatal Cardiac Surgery.

AIM: Neonatal cardiac surgery (NCS) is associated with a risk of neurodevelopmental impairment. We reviewed outcomes of a national pre-school screen, the Before School Check (B4SC), of children who had NCS compared to the national cohort to determine whether NCS children had higher rates of abnormality and whether the B4SC could be useful to identify at-risk NCS children.

METHODS

B4SC results of children who had NCS between 2006 and 2014 were compared to controls. Sub-analyses were performed by cardiac subtype and timing of diagnosis. Outcome measures were the Parental Evaluation of Developmental Status (PEDS), vision and hearing screening, and the Strengths and Difficulties Questionnaire parent version (SDQ-P). Multivariable analysis adjusted for ethnicity, socio-economic positioning, and sex.

RESULTS

Of 508 NCS children, 390 (76.8%) had B4SC outcomes completed. The 371 without a syndrome or chromosomal anomaly, were compared with controls (n = 543 971). NCS children were more likely to have abnormal PEDS (27.9% versus 19.8%, p < 0.001), vision (10.5% versus 5.6%, p < 0.001) and hearing (18.0% versus 9.0%, p < 0.001). There was no difference on SDQ-P. Adjusted for confounding variables, children with single ventricle (SV) had higher rates of abnormal PEDS (RR 1.9, CI 1.4-2.5), whilst SV and 2V with prenatal diagnosis had increased risk of an abnormal vision screen (RR 3.1, CI 1.8-5.5, and 2.2, CI 1.4-3.4). Abnormal hearing screen was increased in all NCS groups.

CONCLUSION

NCS children have higher rates of abnormal PEDS, hearing and vision screening on the B4SC. The B4SC may help to identify at-risk NCS children who may benefit from intervention.