It’s a long title, I know. Let’s break it down: Congenital cardiac issues refers to babies born with a heart defect, and developmental delays could mean any sort of interruption in normal development of executive function, language, social skills, or growth. These two topics may seem quite different, but are actually very much related. There is an inherent link between babies who are born with congenital heart conditions and their development.
Think about it: if a baby is born with a heart condition that requires immediate surgery, follow up appointments, and possible future surgeries all within the first few years of its life, does this baby have the same developmental opportunities as other babies? During the early years of life, it is very important for infants to explore and interact with a variety of environments so they can learn, grow and develop both mentally and physically. However, a baby who spends their first few months of life in a NICU and having heart surgeries does not have this opportunity. Instead, this baby is subjected to stress early in life that can cause a delay in normal development.
It is very common for infants to be seen by physical therapists after undergoing a heart surgery. The goal of this therapy is to help the infant build up their endurance and physical function to avoid the risk of developing a decreased tolerance to exercise and altered sympathetic response to exercise as they grow. However, a baby with a congenital heart defect is not only at a higher risk of delayed physical development, but also mental and neurological development. In fact, studies show that about 50% of these infants will have a neurodevelopmental disability following surgical interventions for congenital heart lesions. Limited opportunities to interact with a variety of environments also puts these infants at a greater risk of having social functioning issues and neurocognitive impairments.
While physical therapy may give these babies new opportunities to explore their environment and move functionally, it is also important that these infants are screened for other neurodevelopmental conditions. As providers, we can perform these screenings and be advocates to make sure these infants receive proper care. For example, children with congenital heart conditions are 33% more likely to be diagnosed with autism. By advocating for early autism screenings for this patient population, we can do our part as healthcare workers to make sure these infants and their families are well supported and have all the resources they need.
Alt. Text: Image from AHA journal article Neurodevelopmental Outcomes in Children with Congenital Heart Disease: Evaluation and Management. The horizontal x-axis of the graph is labeled “Complexity of Congenital heart Disease” and the vertical y-axis is labeled “Prevalence of Neurodevelopmental Impairment.” The far-left column is mostly white, meaning there is a small prevalence of neurodevelopmental impairment with mild complexity congenital heart disease. As you move across the graph to the right, the bars become more light gray (mild or combined disabilities) and dark gray (severe impairment). This shows that as the complexity of the congenital heart disease increases, so does the likelihood of neurodevelopmental impairment.
