| Popis: |
Purpose Neurodevelopmental (ND) delay is described in pediatric heart transplant (HTx) recipients with limited attention to motor outcomes. This study examined ND outcomes in a cohort of young recipients. Methods and Materials Single centre review of ND assessments at ages 1, 2 and 4 yrs included: Alberta Infant Motor Scales (AIMS), Peabody Developmental Motor Scales (PDMS-II), Beery-Buktenica Developmental test of Visual Motor Integration (VMI) and Ages and Stages Questionnaire (ASQ). Results Fourteen children assessed at ages 1, 2 or 4 yrs were 10.6±1.5, 15.0±4.4 and 37.7±15.2 mos post-Tx. Diagnoses included congenital heart disease (8) and cardiomyopathy (6). Average gestational age (GA) was 38.0±2.6 weeks and birth weight (BW) was 3.2±0.6 kgs. Neurologic complications included seizures (2), stroke (2) and intracranial hemorrhage (2). Three of 4 children had AIMS scores th percentile. PDMS-II scores are shown in Table 1. VMI percentile scores were 37.0±33.0% (Median=39, Range:0.7-82). In univariate analysis higher no. of post-Tx admissions (adm) were associated with lower gross (EST: -2.726(1.358) points/adm, p=0.04), fine (EST: -5.661(2.084) points/adm, p=0.01) and total (EST: -4.858(1.967) points/adm, p=0.01) motor scores. Lower BW was associated with lower gross motor scores (EST: -1.30 (0.7) point/100g, p=0.06). Mechanical support (EST: -28.657(8.046) points, p=0.001) and lower GA (EST: -4.077(0.778) points/wks, p=0.001) were associated with lower VMI scores. There were no associations with underlying diagnosis. ASQ results were consistent with standardized assessments. Conclusions Delayed gross and fine motor skill acquisition is common in young heart transplant recipients with a majority meeting criteria for referral for intervention. Further study is warranted to examine long-term implications at school age. Table 1 . PDMS-II Results by AgeAge (yrs)Gross MotorFine MotorTotal Motor125.7±17.041.4±34.636.7±27.126.3±4.716.0±11.07.0±8.5414.2±15.413.8±16.210.6±15.9Percentile scores presented as mean ± SD |
