Abstract
BACKGROUND: Limited studies examined associations between proxies of cerebrovascular autoregulation and neurodevelopmental outcomes (NDOs) in congenital heart disease (CHD). OBJECTIVES: Our objectives were to determine: 1) associations of neonatal cerebrovascular stability index (CSI) and mean regional cerebral oxygenation (rcSO(2)) with 3-month NDOs within CHD and control groups and within CHD subgroups; and 2) group and subgroup differences in these associations. METHODS: This study was a secondary analysis of a longitudinal cohort study in CHD and control infants. We calculated neonatal CSI as: 2-minute mean sitting rcSO(2)-2-minute mean supine rcSO(2). The Bayley-III measured 3-month NDOs. Linear regressions examined associations of CSI and rcSO(2) with NDOs, and interaction terms examined group and subgroup differences in associations. RESULTS: Our sample included 70 infants (41 control and 29 CHD). CSI and rcSO(2) associated with cognitive scores (P = 0.03 and P = 0.02, respectively) in CHD infants. CHD and healthy controls groups differed in associations; CSI positively associated with motor scores (P = 0.02) in CHD, although did not associate in controls, and rcSO(2) positively associated with cognitive scores (P = 0.01) in CHD, although negatively associated in controls. rcSO(2) associated with language scores (P = 0.01) in the biventricular subgroup. CSI associated with motor scores (P = 0.04) and rcSO(2) associated with cognitive scores (P = 0.01) in the cyanotic subgroup. CONCLUSIONS: Neonatal CSI and rcSO(2) associated with 3-month cognitive and motor outcomes in CHD and CHD subgroups, and groups differed in their directional associations. Future studies should explore CSI as an indicator of risk for developmental delays in CHD.