Abstract
Purpose of the study. Assessment of the possibilities of prenatal detection of factors associated with impaired psychomotor development in children with CHD under the age of 16 months.
Material and methods. Forty-five children with prenatally diagnosed CHD were assessed for psychomotor development using the Russian version of the Kent Infant Development Scale. For cases with delayed and normal development of children, a retrospective analysis of the frequency of detection of 5 groups of factors potentially associated with subsequent impaired of the child's development was carried out: clinical, epidemiological and social family factors; fetal factors, including the type of CHD, sex and fetal syndromic pathology; antenatal ultrasonic fetometric and dopplerographic parameters; as well as intra- and neonatal factors, including prematurity, hypoxia at birth.
Results. Slow and normal rates of child development were noted in 13 (28.9%) and 32 (71.1%) cases, respectively. With delayed psychomotor development in the antenatal period, there was a significantly greater number of cases of a decrease in cerebral fetometric parameters: head circumference, biparietal diameter (BPR) and transverse cerebellar diameter (TCD), pulsation index in the middle cerebral artery (PI MCA) and the cerebroplacental ratio (CPR) below the 5th centile (p<0.05), as well as cases with established genetic pathology of the fetus (p = 0.001). All other parameters, including types of congenital heart disease, had no difference in frequency between groups (p>0.05). The odds ratio for a subsequent developmental disorder was 9.4 (1.52–57.7) with a fetal head circumference <10th percentile; 12.9 (2.1–77.7) with PI MCA or CPR < 5th percentile; 19.4 (2.0–190.1) with BPR or TCD < 10th percentile; 25.6 (2.7–257.3) with established syndromic pathology of the fetus.
Conclusion. Antenatal detection of cases with a high risk of subsequent early impaired psychomotor development of a child with CHD can be achieved by mandatory inclusion in the examination protocols of fetuses with cardiac pathology genetic diagnosis, as well as the assessment of the cerebral fetometric and Doppler parameters.
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About the authors
- Tamara A. Yarygina, Cand. Med. Sci., Specialist of Ultrasound Diagnostics, Researcher; ORCID
- Elena I. Leonova, Specialist of Ultrasound Diagnostics; ORCID
- Rena M. Gasanova, Dr. Med. Sci., Head of the Perinatal Cardiology Center; ORCID
- Ol'ga V. Marzoeva, Cand. Med. Sci., Doctor of Ultrasound Diagnostics, Researcher; ORCID
- Elena V. Sypchenko, Cand. Med. Sci., Doctor of Ultrasound Diagnostics; ORCID
- Aleksandr I. Gus, Dr. Med. Sci., Professor; ORCID
