Document Detail


Association of impaired linear growth and worse neurodevelopmental outcome in infants with single ventricle physiology: a report from the pediatric heart network infant single ventricle trial.
MedLine Citation:
PMID:  22939929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To describe neurodevelopmental outcomes in infants with single ventricle (SV) physiology and determine factors associated with worse outcomes.
STUDY DESIGN: Neurodevelopmental outcomes for infants with SV enrolled in a multicenter drug trial were assessed at 14 months of age using the Bayley Scales of Infant Development-II. Multivariable regression analysis was used to identify factors associated with worse outcomes.
RESULTS: Neurodevelopmental testing was performed at 14 ± 1 months in 170/185 subjects in the trial. Hypoplastic left heart syndrome was present in 59% and 75% had undergone the Norwood operation. Mean Psychomotor Developmental Index (PDI) and mental developmental index (MDI) were 80 ± 18 and 96 ± 14, respectively, (normal 100 ± 15, P < .001 for each). Group-based trajectory analysis provided a 2-group model ("high" and "low") for height z-score trajectory and brain type natriuretic peptide (BNP) trajectory. The predicted PDI scores were 15 points higher in the "high" height z-score trajectory compared with the "low" cluster (P < .001). A higher number of serious adverse events during the trial was associated with lower PDI scores (P = .02). The predicted MDI scores were 13-17 points lower in "low height trajectory-high BNP trajectory" group compared with the other 3 groups (P < .001). MDI scores were also lower in subjects who required extracorporeal membrane oxygenation during the neonatal hospitalization (P = .01) or supplemental oxygen at discharge (P = .01).
CONCLUSIONS: Neurodevelopmental outcome at 14 months of age is impaired in infants with SV physiology. Low height trajectory and high BNP trajectory were associated with worse neurodevelopmental outcomes. Efforts to improve nutritional status alone may not improve neurodevelopmental outcomes.
Authors:
Chitra Ravishankar; Victor Zak; Ismee A Williams; David C Bellinger; J William Gaynor; Nancy S Ghanayem; Catherine D Krawczeski; Daniel J Licht; Lynn Mahony; Jane W Newburger; Victoria L Pemberton; Richard V Williams; Renee Sananes; Amanda L Cook; Teresa Atz; Svetlana Khaikin; Daphne T Hsu;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2012-08-30
Journal Detail:
Title:  The Journal of pediatrics     Volume:  162     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-16     Completed Date:  2013-03-11     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  250-6.e2     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00113087
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MeSH Terms
Descriptor/Qualifier:
Child Development*
Developmental Disabilities / drug therapy,  epidemiology,  etiology*,  physiopathology*
Double-Blind Method
Female
Growth*
Heart Ventricles / abnormalities*
Humans
Infant
Male
Prospective Studies
Treatment Outcome
Grant Support
ID/Acronym/Agency:
HL068269/HL/NHLBI NIH HHS; HL068270/HL/NHLBI NIH HHS; HL068279/HL/NHLBI NIH HHS; HL068281/HL/NHLBI NIH HHS; HL068285/HL/NHLBI NIH HHS; HL068288/HL/NHLBI NIH HHS; HL068290/HL/NHLBI NIH HHS; HL068292/HL/NHLBI NIH HHS; HL085057/HL/NHLBI NIH HHS; U01 HL068269/HL/NHLBI NIH HHS; U01 HL068279/HL/NHLBI NIH HHS; U01 HL068281/HL/NHLBI NIH HHS; U01 HL068285/HL/NHLBI NIH HHS; U01 HL068288/HL/NHLBI NIH HHS; U01 HL068290/HL/NHLBI NIH HHS; U01 HL068292/HL/NHLBI NIH HHS; U01 HL085057/HL/NHLBI NIH HHS; UL1 TR000055/TR/NCATS NIH HHS
Investigator
Investigator/Affiliation:
Gail Pearson / ; Victoria Pemberton / ; Mario Stylianou / ; Marsha Mathis / ; Lynn Mahony / ; Lynn Sleeper / ; Steven Colan / ; Lisa Virzi / ; Lisa Wruck / ; Victor Zak / ; David F Teitel / ; Jane W Newburger / ; Roger Breitbart / ; Jami Levine / ; Ellen McGrath / ; Carolyn Dunbar-Masterson / ; Daphne Hsu / ; William Hellenbrand / ; Ashwin Prakash / ; Seema Mital / ; Darlene Servedio / ; Victoria L Vetter / ; Chitra Ravishankar / ; Sarah Tabbutt / ; Meryl Cohen / ; Katherine Lee / ; Marisa Nolan / ; Stephanie Piacentino / ; Michelle Toms / ; D Woodrow Benson / ; Catherine Dent Krawczeski / ; Lois Bogenschutz / ; Teresa Barnard / ; Steven Schwartz / ; David Nelson / ; Page A W Anderson / ; Jennifer Li / ; Wesley Covitz / ; Kari Crawford / ; Michael Hines / ; James Jaggers / ; Theodore Koutlas / ; Charlie Sang / ; Lori Jo Sutton / ; Mingfen Xu / ; J Philip Saul / ; Andrew Atz / ; Girish Shirali / ; Eric M Graham / ; Teresa Atz / ; L LuAnn Minich / ; John A Hawkins / ; Richard V Williams / ; Linda M Lambert / ; Marian E Shearrow / ; Brian McCrindle / ; Elizabeth Radojewski / ; Nancy Slater / ; Svetlana Khaikin / ; Susan McIntyre / ; Nancy Ghanayem / ; Kathy Mussatto / ; Michele Frommelt / ; Lisa Young-Borkowski / ; Albert Rocchini / ; Laurie Rodgers-Augustyniak / ; Steven Colan / ; Renee Margossian / ; Wendy Chung / ; Liyong Deng / ; Patricia Lanzano / ; Michael Artman / ; Judith Massicot-Fisher / ; Timothy Feltes / ; Julie Johnson / ; Thomas Klitzner / ; Jeffrey Krischer / ; G Paul Matherne / ; John Kugler / ; Rae-Ellen Kavey / ; David J Driscoll / ; Mark Galantowicz / ; Sally A Hunsberger / ; Thomas J Knight / ; Holly Taylor / ; Catherine L Webb /
Comments/Corrections

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