August 1, 2012 — The journal Circulation has published new recommendations from the American Heart Association and the American Academy of Pediatrics, recommending that children who are born with heart defects should be screened for developmental disorders. The study raises concern about the long-term health consequences for children who are born with heart defects, especially heart defects caused by medications taken during pregnancy. Some medications, such as the SSRI antidepressant Zoloft, have been linked to an increased risk of heart defects.
The researchers reviewed medical records for children born with heart defects between 1966 and 2011 and compared them to children born without heart defects. They found that heart defects increased the risk that the child will have difficulty in school, behavioral issues, poor social skills, or problems with language and speech development.
The risk of long-term developmental disorders was highest for children who had open heart surgery. Another major risk factor was cyanosis, in which the heart defect limits the amount of oxygenated blood that reaches the child’s internal organs. Sometimes, children must endure prolonged cyanosis for several months, until they are strong enough for the surgeon to correct the heart defect. This lack of oxygen could have long-term impact on a child’s neurological development.
Certain risk factors made these children more likely to have developmental disorders:
- Premature birth
- Developmental delays
- Genetic abnormality
- A history of mechanical support for heart function
- Heart transplant
- A history of cardiopulmonary resuscitation (CPR)
- Prolonged hospitalization due to the heart defect
- Seizures from heart surgery
- Brain abnormalities or brain damage
Early screening could help children with these developmental disorders get proper treatment. Experts recommend that high-risk children should have periodic evaluations of neurological development throughout infancy, at 12-24 months of age, 3-5 years, and 11-12 years of age.
In some cases, early intervention services may be recommended even before a developmental disorder is officially diagnosed. Later in life, the child may benefit form vocational counseling or other therapies as they transition to adulthood.
Approximately 1-2% of babies are born with a heart defect. As medical technology has improved, so has the survival rate for these children. Approximately 85% of children born with a heart defect survive into adulthood.
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