Heart Defects May Have Lasting Neurological Effects

August 1, 2012 — Experts are recommending that children who were born with heart defects should be screened for neurological and developmental disorders, according to the American Heart Association and the American Academy of Pediatrics. The recommendations were prompted after a study published in Circulation found that children born with heart defects are more likely to have problems in school, behavioral issues, poor social skills, or problems with speech, language, and learning.

The study raises concern about the long-term impact of drug induced birth defects. SSRI antidepressants such as Zoloft (sertraline) have been linked to an increased risk of birth defects. Babies who are born with heart defects may need long-term care.

The researchers collected medical records from 1966 until 2011, and compared children born with and without heart defects. The risk of severe neurological and developmental disorders was greatest for children who required open heart surgery or had oxygen deprivation very early in life.

Many severe types of heart defects cause a condition called cyanosis (or “blue baby syndrome”) in which the heart is unable to supply the body with enough oxygen. This causes the baby’s skin, lips, and nails to turn blue. In some cases, children must remain somewhat cyanotic for months, until they are strong enough to survive surgery to repair their heart defect. Not surprisingly, this long-term oxygen deprivation can have profound neurological impacts.

Other risk factors also increased the risk of 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

The researchers recommended that high-risk children should have periodic screening for developmental delays or neurological disorders. These screenings should be performed in infancy, at 12-24 months, 3-5 years, and 11-12 years of age. Early diagnosis of disorders could help the child receive intervention services, which could improve the child’s long-term prognosis.

An estimated 1-2% of all babies are born with a heart defect, and the cause is often unknown. Certain medications taken during pregnancy could increase the risk of heart defects. Fortunately, advances in medical technology have significantly improved the survival rate — 85% of children with heart defects survive to adulthood.

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