Neurological Development in Very Low Birth Weight Infants with Congenital Heart Disease at 3 Years of Age: A Japanese Multicenter Study.

Neurodevelopmental impairment is an increasing concern in very low birth weight (VLBW) infants with congenital heart disease (CHD). However, their prevalence and associated risk factors remain poorly defined. We aimed to investigate the neurodevelopmental outcomes and identify risk factors for impairment in this vulnerable population. This multicenter cohort study included VLBW infants born between 2006 and 2014 without genetic or known anomalies. Neurodevelopment was assessed at three years of age using the Kyoto Scale of Psychological Developmental (KSPD). Poor neurodevelopment was defined as a total developmental quotient (DQ) < 70, a diagnosis of cerebral palsy, or clinical judgment in cases where the KSPD was not administered. Among 52 infants with CHD and 189 without, poor neurodevelopment outcomes were significantly more frequent in the CHD group (36.5% vs.16.4%, p = 0.003), particularly in those with serious CHD (54.9%). Multivariate logistic regression identified serious CHD and prolonged hospitalization (> 13 weeks) as independent risk factors. These findings highlight the need for early identification and multidisciplinary follow-up in this high-risk populations.