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Gender differences in the developmental outcomes of children with congenital cardiac defects

Published online by Cambridge University Press:  25 January 2012

Annette Majnemer ,
Catherine Limperopoulos ,
Michael Shevell ,
Charles Rohlicek ,
Bernard Rosenblatt  and
Christo Tchervenkov
Annette Majnemer*
Affiliation:
School of Physical & Occupational Therapy, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada Department of Pediatrics, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada Departments of Neurology & Neurosurgery, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
Catherine Limperopoulos
Affiliation:
Division of Diagnostic Imaging & Radiology, George Washington University Medical Center, Children's National Medical Center, Washington, DC, United States of America
Michael Shevell
Affiliation:
Department of Pediatrics, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada Departments of Neurology & Neurosurgery, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
Charles Rohlicek
Affiliation:
Department of Pediatrics, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
Bernard Rosenblatt
Affiliation:
Department of Pediatrics, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada Departments of Neurology & Neurosurgery, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
Christo Tchervenkov
Affiliation:
Pediatric Cardiovascular Surgery, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
*
Correspondence to: Dr A. Majnemer, OT, PhD, School of Physical & Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal, Quebec, Canada H3G 1Y5. Tel: +514 412 4400x22902; Fax: +514 412 4373; E-mail: [email protected]
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Abstract

Objective

This study compares the developmental and functional outcomes at school entry between boys and girls born with a congenital cardiac defect who required early surgical correction.

Study design

A prospective cohort of 94 children, including 49 percent boys, were followed up to 5 years of age and assessed for developmental progress. Developmental measures included Wechsler Preschool and Primary Scale of Intelligence – cognitive; Peabody Picture Vocabulary Test – receptive language; Peabody Developmental Motor Scale – motor; and Child Behaviour Checklist – behaviour. Measures of function included the Vineland Adaptive Behavior Scale and Functional Independence Measure for Children (WeeFIM).

Results

The mean scores of the boys on the WeeFIM subscales, such as self-care, mobility, cognition, were significantly lower than that of the girls. There was a trend for a greater proportion of boys to have abnormalities on neurological examination (boys 37.5 percent abnormal, girls 19.5 percent abnormal). Verbal, performance, and full scale Intellectual Quotients were 5–7 points lower in boys but did not reach significance (full scale Intellectual Quotient: boys 87.7 plus or minus 22.2; girls 93.9 plus or minus 19.3). Boys were more likely to have fine motor delays (50 percent, 82.7 plus or minus 16.5) compared with girls (28.2 percent, 87.0 plus or minus 15.8). There were no gender differences in receptive language or behavioural difficulties.

Conclusions

Boys born with congenital heart disease requiring early surgical repair appear to be at enhanced risk for neuromotor impairments and activity limitations. Findings support gender differences in the pathogenesis of early brain injury following hypoxic–ischaemic insults. This has implications for neuroprotective strategies to prevent brain injury.

Keywords

Malemotor delayintelligence quotientactivity limitations
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 5 , 13 September 2012 , pp. 514 - 519
Copyright
Copyright © Cambridge University Press 2012

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