Inserm, University Paris Descartes, Sorbonne Paris Cité, Faculty of Medicine, and APHP, Necker Hospital, Paris, France.
J Pediatr. 2012 Jul;161(1):94-8.e1. doi: 10.1016/j.jpeds.2011.12.036. Epub 2012 Jan 28.
To assess the effect of prenatal diagnosis of congenital heart disease on neurocognitive outcomes in children with d-transposition of the great arteries (TGA) after surgical correction.
A prospective study of children born with a TGA between 2003 and 2005 and aged 4 to 6 years was conducted. General intelligence, language, executive functions, and social cognition scores and preoperative, intraoperative, and postoperative factors were evaluated according to time of TGA diagnosis. Neurocognitive data were also compared with a control group.
Forty-five eligible patients (67% male) were examined; 29 had a prenatal diagnosis of TGA and 16 did not. All children were comparable in age, sex, and demographic variables. Diagnostic groups did not differ in preoperative, intraoperative, and postoperative variables. Preoperative acidosis was more frequent in the postnatal group (18% versus 3%). All patients had normal IQ scores, language, and verbal working memory. However, neurocognitive deficits were more prevalent and more severe in children with a postnatal-TGA. Prenatal diagnosis was associated with better outcomes in executive functions.
Prenatal diagnosis of TGA is associated with better neurocognitive outcomes. Time of diagnosis may influence the development of early complex cognitive skills such as executive functions.
评估先天性心脏病产前诊断对大动脉转位（TGA）患儿手术后神经认知结局的影响。
对 2003 年至 2005 年间出生的 TGA 患儿进行前瞻性研究，年龄在 4 至 6 岁之间。根据 TGA 诊断时间评估一般智力、语言、执行功能和社会认知评分以及术前、术中及术后的相关因素。并将神经认知数据与对照组进行比较。
共检查了 45 名符合条件的患者（67%为男性）；其中 29 名患儿有 TGA 的产前诊断，16 名患儿没有。所有患儿在年龄、性别和人口统计学变量方面均具有可比性。诊断组在术前、术中及术后变量上无差异。出生后组的术前酸中毒更为常见（18%比 3%）。所有患者的智商、语言和言语工作记忆均正常。然而，在出生后 TGA 患儿中，神经认知缺陷更为普遍且更为严重。产前诊断与更好的执行功能结局相关。
TGA 的产前诊断与更好的神经认知结局相关。诊断时间可能会影响早期复杂认知技能（如执行功能）的发展。
