Abstract：
OBJECTIVE: In patients with transposition of the great arteries, surgical correction may achieve definitive treatment, so a thorough knowledge of the long-term outcomes, particularly neurodevelopment outcomes, is essential. Therefore, we conducted a systematic review and meta-analysis to study the neurodevelopment outcomes in the first 5 years of the life of children submitted to corrective surgery for transposition of the great arteries in the neonatal period.
METHODS: A total of 17 studies from 18 reports were included, assessing 809 individuals with surgically corrected transposition of the great arteries. The neurodevelopmental outcomes were assessed with the Bayley Scales of Infant and Toddler Development (BSID) and the Wechsler Intelligence Scale for Children (WISC).
RESULTS: Mean Mental Development Index (MDI) and Psychomotor Development Index (PDI) were within the average values from 1 to 3 years of age, although the proportion of children scoring more than 1 standard deviation below the mean in PDI, MDI, motor, and language composite scores was significantly higher than in the general population. From 4 to 5 years, mean full-scale global intelligence quotient (IQ), verbal IQ, and performance IQ scores did not differ significantly from the general population.
CONCLUSIONS: This study revealed neurodevelopment scores within the normal range at 5 years of age in children submitted to corrective surgery for transposition of the great arteries in the neonatal period. However, these early outcomes may not adequately predict long-term outcomes. Further studies are needed to identify specific risk factors and early markers of later impairment to guide the establishment of early interventions.
METHODS: A total of 17 studies from 18 reports were included, assessing 809 individuals with surgically corrected transposition of the great arteries. The neurodevelopmental outcomes were assessed with the Bayley Scales of Infant and Toddler Development (BSID) and the Wechsler Intelligence Scale for Children (WISC).
RESULTS: Mean Mental Development Index (MDI) and Psychomotor Development Index (PDI) were within the average values from 1 to 3 years of age, although the proportion of children scoring more than 1 standard deviation below the mean in PDI, MDI, motor, and language composite scores was significantly higher than in the general population. From 4 to 5 years, mean full-scale global intelligence quotient (IQ), verbal IQ, and performance IQ scores did not differ significantly from the general population.
CONCLUSIONS: This study revealed neurodevelopment scores within the normal range at 5 years of age in children submitted to corrective surgery for transposition of the great arteries in the neonatal period. However, these early outcomes may not adequately predict long-term outcomes. Further studies are needed to identify specific risk factors and early markers of later impairment to guide the establishment of early interventions.
摘要：
目的：在大动脉转位患者中，手术矫正可能会达到明确的治疗，所以对长期结果有透彻的了解，特别是神经发育结果，是必不可少的。因此,我们进行了系统评价和荟萃分析,以研究在新生儿期接受大动脉转位矫正手术的儿童的前5年神经发育结局.
方法：共纳入18份报告中的17项研究，评估809例经手术矫正的大动脉转位患者。使用Bayley婴幼儿发育量表（BSID）和韦氏儿童智力量表（WISC）评估神经发育结果。
结果：平均精神发育指数（MDI）和精神运动发育指数（PDI）在1至3岁的平均值内，尽管在PDI中得分低于平均值1个标准差以上的儿童比例，MDI,电机,语言综合得分明显高于一般人群。从4到5年,平均全面全球智商(IQ)，言语智商,和表现智商得分与普通人群没有显着差异。
结论：这项研究显示，在新生儿期接受大动脉转位矫正手术的儿童中，5岁时的神经发育评分在正常范围内。然而,这些早期结局可能无法充分预测长期结局.需要进一步的研究来确定特定的风险因素和后期损害的早期标志物，以指导早期干预措施的建立。
方法：共纳入18份报告中的17项研究，评估809例经手术矫正的大动脉转位患者。使用Bayley婴幼儿发育量表（BSID）和韦氏儿童智力量表（WISC）评估神经发育结果。
结果：平均精神发育指数（MDI）和精神运动发育指数（PDI）在1至3岁的平均值内，尽管在PDI中得分低于平均值1个标准差以上的儿童比例，MDI,电机,语言综合得分明显高于一般人群。从4到5年,平均全面全球智商(IQ)，言语智商,和表现智商得分与普通人群没有显着差异。
结论：这项研究显示，在新生儿期接受大动脉转位矫正手术的儿童中，5岁时的神经发育评分在正常范围内。然而,这些早期结局可能无法充分预测长期结局.需要进一步的研究来确定特定的风险因素和后期损害的早期标志物，以指导早期干预措施的建立。
