INS NYC 2024 Program

Poster	Poster Session 10 Program Schedule 02/17/2024 09:00 am - 10:15 am Room: Majestic Complex (Posters 61-120) Poster Session 10: Neurodevelopmental \| Congenital Conditions Final Abstract #102 Congenital Heart Disease and Prematurity: Similarities and Differences in Outcomes and Access Molly Winston, Children's Healthcare of Atlanta, Atlanta, United States Susan Lee, Children's Healthcare of Atlanta, Atlanta, United States Dawn Ilardi, Children's Healthcare of Atlanta, Atlanta, United States Category: Prenatal/Perinatal Factors/Prematurity Keyword 1: prematurity Keyword 2: congenital disorders Keyword 3: pediatric neuropsychology Objective: Premature birth (i.e., <37 weeks gestation) and congenital heart disease (CHD) encompass two of the leading causes for perinatal complications with significant neurodevelopmental (ND) implications. In the ND outcome literature for CHD, prematurity is conceptualized as a comorbidity and includes a small subgroup of patients with limited data available about the ND outcomes for patients with both prematurity and CHD. Moreover, although the scientific and medical communities have put forth statements about monitoring ND outcomes across both populations, follow-up programs are very different, and may affect access to services and overall outcomes. This study aims to characterize similarities and differences in service access and ND outcomes for children with CHD only, prematurity only (PREM), and CHD with prematurity (CHDPREM). It is hypothesized that the CHDPREM group will have poorer ND outcomes, but groups with prematurity will have better access to services. Participants and Methods: Retrospective data were collected from patients referred for a neuropsychological evaluation at Children’s Healthcare of Atlanta (IRB approved). The initial sample (ages 4-20) includes 164 participants (CHDPREM=34, CHD=71, PREM=59). ND measures include comprehensive neurocognitive data and psychosocial functioning. Sociodemographic, medical, and service access data was also collected. Initial analyses are descriptive and explore group differences in rates of service access and select ND outcomes. Upcoming analyses will include statistical modeling to explore the impact of the risk and protective factors on comprehensive ND outcomes across age-matched groups. Results: Results: Preliminary analyses show the PREM group was younger at evaluation, had lower gestational age, and lower birthweight compared to CHD and CHDPREM groups (p<.001). PREM had the highest rate of neuroimaging [head ultrasounds (HUS), MRI, or CT], with 100% receiving at least HUS at birth (42% abnormal; p<.001). In contrast 50% of CHDPREM received neuroimaging (35% abnormal), and 59% of CHD had neuroimaging (45% abnormal). PREM had the highest participation in early intervention at 71%, followed by CHD at 24%, and then CHDPREM at 18% (p<.001). This pattern is consistent with the rate of school services received across groups. Regarding ND outcomes, CHDPREM had increased parent-reported Behavioral Symptoms and reduced Adaptive Skills on the BASC-3 (p=.092, p<.001, respectively). Furthermore, CHDPREM had increased executive functioning difficulties (BRIEF-2 Global Executive Composite; p=.070). Parent-reported adaptive functioning (ABAS-3) and academic achievement (WIAT-3; Reading, Math) did not significantly differ between groups (ps>.11); although the means across groups fell below the normative sample. Future analyses will include data from additional neurocognitive domains. Conclusions: Conclusions: Preliminary results for the present sample of individuals with CHD, CHDPREM, and PREM, highlight disparate practices for early neuroimaging and unequal service access across the populations, with PREM having the highest rate of both compared to the CHD groups. Initial analyses of ND outcomes show increased parent-reported behavioral and cognitive difficulties in CHDPREM. Results will be used to inform clinical recommendations for initial assessment and long-term follow up in these comparable high risk groups.

Poster

02/17/2024
09:00 am - 10:15 am
Room: Majestic Complex (Posters 61-120)

Poster Session 10: Neurodevelopmental | Congenital Conditions

Final Abstract #102

Congenital Heart Disease and Prematurity: Similarities and Differences in Outcomes and Access

Molly Winston, Children's Healthcare of Atlanta, Atlanta, United States
Susan Lee, Children's Healthcare of Atlanta, Atlanta, United States
Dawn Ilardi, Children's Healthcare of Atlanta, Atlanta, United States

Category: Prenatal/Perinatal Factors/Prematurity

Keyword 1: prematurity
Keyword 2: congenital disorders
Keyword 3: pediatric neuropsychology

Objective:

Premature birth (i.e., <37 weeks gestation) and congenital heart disease (CHD) encompass two of the leading causes for perinatal complications with significant neurodevelopmental (ND) implications. In the ND outcome literature for CHD, prematurity is conceptualized as a comorbidity and includes a small subgroup of patients with limited data available about the ND outcomes for patients with both prematurity and CHD. Moreover, although the scientific and medical communities have put forth statements about monitoring ND outcomes across both populations, follow-up programs are very different, and may affect access to services and overall outcomes. This study aims to characterize similarities and differences in service access and ND outcomes for children with CHD only, prematurity only (PREM), and CHD with prematurity (CHDPREM). It is hypothesized that the CHDPREM group will have poorer ND outcomes, but groups with prematurity will have better access to services.

Participants and Methods:

Retrospective data were collected from patients referred for a neuropsychological evaluation at Children’s Healthcare of Atlanta (IRB approved). The initial sample (ages 4-20) includes 164 participants (CHDPREM=34, CHD=71, PREM=59). ND measures include comprehensive neurocognitive data and psychosocial functioning. Sociodemographic, medical, and service access data was also collected. Initial analyses are descriptive and explore group differences in rates of service access and select ND outcomes. Upcoming analyses will include statistical modeling to explore the impact of the risk and protective factors on comprehensive ND outcomes across age-matched groups.

Results:

Results: Preliminary analyses show the PREM group was younger at evaluation, had lower gestational age, and lower birthweight compared to CHD and CHDPREM groups (p<.001). PREM had the highest rate of neuroimaging [head ultrasounds (HUS), MRI, or CT], with 100% receiving at least HUS at birth (42% abnormal; p<.001). In contrast 50% of CHDPREM received neuroimaging (35% abnormal), and 59% of CHD had neuroimaging (45% abnormal). PREM had the highest participation in early intervention at 71%, followed by CHD at 24%, and then CHDPREM at 18% (p<.001). This pattern is consistent with the rate of school services received across groups. Regarding ND outcomes, CHDPREM had increased parent-reported Behavioral Symptoms and reduced Adaptive Skills on the BASC-3 (p=.092, p<.001, respectively). Furthermore, CHDPREM had increased executive functioning difficulties (BRIEF-2 Global Executive Composite; p=.070). Parent-reported adaptive functioning (ABAS-3) and academic achievement (WIAT-3; Reading, Math) did not significantly differ between groups (ps>.11); although the means across groups fell below the normative sample. Future analyses will include data from additional neurocognitive domains.

Conclusions:

Conclusions: Preliminary results for the present sample of individuals with CHD, CHDPREM, and PREM, highlight disparate practices for early neuroimaging and unequal service access across the populations, with PREM having the highest rate of both compared to the CHD groups. Initial analyses of ND outcomes show increased parent-reported behavioral and cognitive difficulties in CHDPREM. Results will be used to inform clinical recommendations for initial assessment and long-term follow up in these comparable high risk groups.