SES, clinical factors trump brain MRI in predicting long-term neurodevelopment in coronary infants | Latest news for doctors, nurses and pharmacists

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In infants with congenital heart disease (CHD), perioperative clinical course and socioeconomic status (SES) appear to be better predictors of long-term neurodevelopmental outcomes than conventional neonatal brain magnetic resonance imaging (MRI), according to a new study.

Researchers conducted a prospective cohort analysis of 57 term infants receiving cardiopulmonary bypass for coronary artery disease. All participants underwent perioperative brain MRI screening, the images of which were evaluated by a trained professional to produce a Brain Injury Severity Score (BIS) for each patient.

The outcome of the study was neurodevelopment, assessed using the Wechsler Preschool and Primary Intelligence Scale 3rd Edition (WPPSI-III) at a median age of 6.0 years.

In the perioperative period, more than a quarter (26.3%; n = 15) of patients had moderate to severe brain damage, according to the BIS classification. Meanwhile, the total, verbal, and performance IQ of coronary children at age 6 did not differ from normative means. Nevertheless, processing speed, motor score, and motor coordination were all significantly worse in the CHD cohort, while visual perception was better.

Multiple linear regression analysis revealed that log of hospital stay (B, 19.39; p=0.004) and SES (B, 2.99; p measured at preschool age. In contrast, MRI factors, such as postoperative total brain volume (p = 0.46) and cumulative BIS score (p = 0.57) were not.

“These findings underscore the importance of early therapeutic support for low-SES children with long hospital stays,” the researchers said.


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