Association between pediatric feeding disorders (PFD) and suboptimal neurodevelopment (SND) in infants with congenital heart disease requiring bypass surgery in the first year of life: Results from a single-center prospective observational study - 08/01/26
, S. Joriot 2, S. Nguyen The Tich 2, L. Chaton 3, A. Persyn 4, M. Recher 5, J.B. Baudelet 4, F. Godart 6, F. Juthier 7, G. Riccardi 4, S. Delangue 5, M. Dubernet 8, C. Etienne 9, O. Domanski 6Résumé |
Introduction |
Suboptimal neurodevelopmental (SND) issues affect 30 to 60% of infants with congenital heart disease, cardiac surgery before 1 year old being a major risk factor. Pediatric feeding disorders (PFD) are the second most common comorbidity among these patients.
Objective |
We ought to demonstrate the association between PFD and SND in this population.
Method |
We conducted a single-center prospective cohort study evaluating the association between PFD, as defined by Goday et al., diagnosed by a speech therapist and SND at twelve months in children who underwent surgery with cardiopulmonary bypass (CPB) before the age of one, at Lille University Hospital between October 2020 and February 2024. Patients were part of a systematic monitoring protocol of our institution.
Results |
We included 45 patients. Preoperatively, 38% of infants had a PFD, compared to 29% at 12 months ( Fig. 1a ). Additionally, 77% showed suboptimal neurodevelopment (SND) defined by ASQ < 2SD and/or AIMS < 5th percentile) at 12 months ( Fig. 1c ). No significant association was found between PFD and neurodevelopment at 12 months, but preoperative PFD was linked to SND at 12 months ( P = 0.03). Infants with preoperative PFD were more cyanotic before surgery ( P = 0.017), underwent surgery at an older age ( P = 0.013), and had a smaller head circumference at 12 months ( P = 0.006) compared to those without feeding disorders. The presence of a nasogastric tube (NGT) was associated with preoperative PFD ( P = 0.01), and with 12 months PFD ( P = 0.01) but positive predictive value was low (VPP respectively 61% and 50%). NGT pre or postoperatively was not significantly associated with neurodevelopment outcome at 12 months. But 12 months PFD was associated with lower ASQ communication result ( P = 0.04).
Conclusion |
Infants undergoing surgery for congenital heart disease under CPB frequently present PFD. Feeding difficulties diagnosed by speech therapists (and not only the presence of a feeding tube) appearing before surgery is associated with a non-optimal neurodevelopmental trajectory at 12 months. Early identification of a PFD could serve as a warning signal to identify the risks of a non-optimal neurodevelopmental trajectory and thus optimize management.
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Vol 119 - N° 1S
P. S153-S154 - janvier 2026 Retour au numéro
Article précédent
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