Factors affecting motor development of toddlers who received cardiac corrective procedures during infancy.

Abstract

BACKGROUND\nA risk adjustment in congenital heart surgery (RACHS-1) method was used for assessing quality of care in children undergoing congenital heart surgery. Children in RACHS-1 categories 1-4 had high survival rates. Little was known about these children and their prognosis of motor development during toddlerhood.\n\n\nAIMS\nTo compare the differences between congenital heart disease (CHD) and healthy toddlers in terms of their characteristics, parental characteristics, parenting attitudes, and motor development, and further examine the influence of these factors on the motor development of the toddler with CHD.\n\n\nSTUDY DESIGN\nA comparison study.\n\n\nSUBJECTS\nThere were 48 toddlers in the CHD group and 39 in the healthy toddler group.\n\n\nOUTCOMES MEASURES\nCurrent height and weight, Peabody Developmental Motor Scales second edition (PDMS-2), state-trait anxiety inventory (STAI) and Child Vulnerability Scale (CVS).\n\n\nRESULTS\nCompared to the healthy group, toddlers with CHD had lower birth weight, smaller height-for-age, lower weight-for-age, and more motor developmental delay, but their mothers had lower anxiety. A shorter length of hospitalization and higher weight-for-age z score predicted a better gross motor development, with 40.2% of the variance explained. A higher weight-for-age z score and low RACHS-1 categories predicted better total motor development, with 38.4% of the variance explained. Only low RACHS-1 categories predicted better fine-motor development, with 12% of the variance explained.\n\n\nCONCLUSIONS\nMany children in RACHS-1 categories 1-4 had growth and motor development below average in their toddlerhood. Therefore, growth and developmental progress should be assessed and mediated early after corrective procedures.