Project details

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Motor development in infants with complex congenital heart disease

Keywords:
infant Motor development complex congenital heart disease

Researchers:
Prof. dr. M. Hadders-Algra
D. Huisenga

Nature of the research:
Observational

Fields of study:
pediatrics neurology

Background / introduction
Some 40 years ago virtually all children with complex congenital heart disease (CCHD) died. However, with advances in diagnostic technologies, surgical management, and postoperative care, over 90% of children with CCHD are expected to survive to adulthood in the current era. A recent systematic review and meta-analyses revealed that the significant success of these advances has exposed a heightened risk of brain injury and developmental disorders and disabilities.1 Early detection of the infants with CCDH, who will develop a disorder, is therefore mandatory, as this offers the need of early intervention at a phase in life characterized by high neuroplasticity.2
Research question / problem definition
Is the increased risk of developmental disorders in infants with CCHD expressed in their motor development as measured with the Infant Motor Profile (IMP)? Are infants with single ventricle physiology CCHD more at risk of atypical IMP-scores than infants with two-ventricle physiology CCHD? Is the risk associated with chronic hypoxaemia?
Workplan
A cohort of infants with CCHD (n=72) who had had surgery at Advocate Christ Medical Center/Advocate Children’s Hospital, Oak Lawn, IL, USA in 2015-2019 were longitudinally assessed with the IMP at the age of 6, 12 and 18 months. The IMP is a video based standardized assessment of the infant’s self-produced motor behaviour. It has five domains: variation, adaptability, symmetry, fluency and performance.
The student’s task is to assess (under supervision) the IMP-video assessments and to analyze associations between IMP-scores and cardiac risk factors.
The study will result in advanced knowledge about the neuromotor development in infants with CCHD, about which infants are most vulnerable to develop disorders and which infants may benefit most from early intervention.
References
1. Huisenga D, La Bastide-van Gemert S, Van Bergen A, Sweeney J, Hadders-Algra M. Developmental outcomes after early surgery for complex congenital heart disease: a systematic review and meta-analysis. Dev Med Child Neurol 2020, epub ahead of print.
2. Hadders-Algra M. Early diagnosis and early intervention in cerebral palsy. Front Neurol. 2014 Sep 24;5: 185. doi: 10.3389/fneur.2014.00185.
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