Prevalence and Patterns of Neuro-developmental problems among children with Congenital Heart Diseases attending a tertiary institution in South East Nigeria

Abstract

BackgroundContinued progress in early diagnosis and therapeutic options has contributed to the increased survival of infants with CHD with attendant NDD which is of profound personal and public health significance.AimTo determine the prevalence and patterns of neuro-developmental problems in children with CHD.Methods A cross-sectional study consisting of 40 children with CHD attending the Cardiology clinic of University of Nigeria Teaching Hospital (UNTH), as well as 40 age and gender-matched controls with no heart disease recruited from children’s outpatient and well-baby clinics. A semi-structured pretested questionnaire was used in documenting socio-demographic data. General and systemic examinations including cardiovascular and central nervous system assessments were done. The echocardiography report from UNTH was reviewed and the type of CHD documented. Neurodevelopmental assessment using The Malawi Developmental Assessment Tool (MDAT) was carried out by the researchers. Data were analysed using IBM Statistical Package for Social Sciences (SPSS 20.0 version). Chi-Square were used to compare age and gender and other demographic variables with Yates correction where appropriate. Bivariate analysis was performed using the type of CHD to identify cardiac lesions associated with NDD. Significant statistical level was set as a p-value < 0.05. Results Forty subjects and 40 controls aged 6-60months with a male to female ratio of 3:2 were studied. Thirty-seven (92.5%) of the subjects had one or more symptoms of CHD. NDD was noted in 23 (57.50%) children with CHD compared to six (15.0%) of the controls. (χ = 15.63, p< 0.0008). The differences in the number of children with delay across all domains for both groups were (p= <0.001). While 17 (42.5%) patients with CHD had a delay in more than one domain (global delay), none of the control had a delay in more than one domain. The difference in the number of domains with NDD for patients and their controls was statistically significant (p<0.001). Though there is no significant correlation between age (χ2 =7.243; p = 0.203) and gender (χ2 =0.017; p = 0.896) of children with NDD, the younger age group were more affected. NDD was also commoner in children with Tetralogy of Fallot (TOF) 5 (62.5%). Conclusion NDD was common in children with CHD and a significant number had a global delay when compared with their controls.