Neurodevelopmental assessment of children with congenital heart disease: a Meta analysis based on the Bayley Scales of Infant Development and Wechsler Intelligence Scale

Meng-Ting SUN; Man-Jun LUO; Jia-Peng TANG; Ye CHEN; Ke-Bin CHEN; Qi ZOU; Xiao-Rui RUAN; Yuan PENG; Zhan-Wen LI; Yu-Ting WEN; Cheng-Lu ZHOU; Ting-Ting WANG; Jia-Bi QIN

doi:10.7499/j.issn.1008-8830.2503068

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Chinese Journal of Contemporary Pediatrics ›› 2026, Vol. 28 ›› Issue (1) : 30-41. DOI: 10.7499/j.issn.1008-8830.2503068

CLINICAL RESEARCH

Neurodevelopmental assessment of children with congenital heart disease: a Meta analysis based on the Bayley Scales of Infant Development and Wechsler Intelligence Scale

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Abstract

Objective To systematically evaluate neurodevelopmental differences between children with congenital heart disease (CHD) and healthy controls. Methods A comprehensive search was conducted in Web of Science, PubMed, Embase, Wanfang Data, China National Knowledge Infrastructure, Chinese Biomedical Literature Service System, and VIP Database to identify studies published from database inception to February 2025 that assessed the neurodevelopment of children with CHD (CHD group) and healthy controls (control group) using the Bayley Scales of Infant Development (BSID) and the Wechsler Intelligence Scale. In total, 33 studies involving 3 316 children were included. Hedges' g was used as the effect size. Meta analysis, subgroup analysis, sensitivity analysis, and publication bias analysis were performed using STATA/SE 17.0. Results Based on BSID-II, compared with the control group, the CHD group had significantly lower mental development index (Hedges' g=-1.09) and psychomotor development index (Hedges' g=-1.22) scores (both P<0.001). Based on BSID-III, compared with the control group, the CHD group had markedly lower scores in cognition (Hedges' g=-0.78), language (Hedges' g=-0.65), and motor (Hedges' g=-0.98) (all P<0.001). The Wechsler Intelligence Scale indicated that, compared with the control group, the CHD group had significantly lower full-scale intelligence quotient (Hedges' g=-0.74), verbal intelligence quotient (Hedges' g=-0.86), and performance intelligence quotient (Hedges' g=-0.67) (all P<0.001). Conclusions Children with CHD exhibit developmental delays in cognition, language, motor function, and intelligence.

Key words

Congenital heart disease / Neurodevelopment / Bayley Scales of Infant Development / Wechsler Intelligence Scale / Child

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Meng-Ting SUN , Man-Jun LUO , Jia-Peng TANG , et al . Neurodevelopmental assessment of children with congenital heart disease: a Meta analysis based on the Bayley Scales of Infant Development and Wechsler Intelligence Scale[J]. Chinese Journal of Contemporary Pediatrics. 2026, 28(1): 30-41 https://doi.org/10.7499/j.issn.1008-8830.2503068

References

List( Publishing order | Descend order by publishing year | Descend order by cited within ) Chart analysis

[1]

Liu

, Chen

, Zühlke

, et al. Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies[J]. Int J Epidemiol, 2019, 48(2): 455-463. PMCID: PMC6469300. DOI: 10.1093/ije/dyz009 .

https://www.ncbi.nlm.nih.gov/pubmed/30783674

Cited in this article [1]

[2]

Zhao

, Chen

, Yang

, et al. Birth prevalence of congenital heart disease in China, 1980-2019: a systematic review and meta-analysis of 617 studies[J]. Eur J Epidemiol, 2020, 35(7): 631-642. PMCID: PMC7387380. DOI: 10.1007/s10654-020-00653-0 .

https://www.ncbi.nlm.nih.gov/pubmed/32519018

Cited in this article [1]

[3]	Zhao QM, Liu F, Wu L, et al. Prevalence of congenital heart disease at live birth in China[J]. J Pediatr, 2019, 204: 53-58. DOI: 10.1016/j.jpeds.2018.08.040 . https://www.ncbi.nlm.nih.gov/pubmed/30270157 Cited in this article [1]

[4]	Latal B. Neurodevelopmental outcomes of the child with congenital heart disease[J]. Clin Perinatol, 2016, 43(1): 173-185. DOI: 10.1016/j.clp.2015.11.012 . https://www.ncbi.nlm.nih.gov/pubmed/26876129 Cited in this article [1]

[5]

Sun

, Macgowan

, Sled

, et al. Reduced fetal cerebral oxygen consumption is associated with smaller brain size in fetuses with congenital heart disease[J]. Circulation, 2015, 131(15): 1313-1323. PMCID: PMC4398654. DOI: 10.1161/CIRCULATIONAHA.114.013051 .

https://www.ncbi.nlm.nih.gov/pubmed/25762062

Cited in this article [1]

[6]	Lim JM, Kingdom T, Saini B, et al. Cerebral oxygen delivery is reduced in newborns with congenital heart disease[J]. J Thorac Cardiovasc Surg, 2016, 152(4): 1095-1103. DOI: 10.1016/j.jtcvs.2016.05.027 . https://www.ncbi.nlm.nih.gov/pubmed/27349283 Cited in this article [1]

[7]	Miatton M, De Wolf D, François K, et al. Neurocognitive consequences of surgically corrected congenital heart defects: a review[J]. Neuropsychol Rev, 2006, 16(2): 65-85. DOI: 10.1007/s11065-006-9005-7 . https://www.ncbi.nlm.nih.gov/pubmed/16960756 Cited in this article [1]

[8]	Gaynor JW, Stopp C, Wypij D, et al. Neurodevelopmental outcomes after cardiac surgery in infancy[J]. Pediatrics, 2015, 135(5): 816-825. PMCID: PMC4533222. DOI: 10.1542/peds.2014-3825 . https://www.ncbi.nlm.nih.gov/pubmed/25917996 Cited in this article [1]

[9]	Wells GA, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses[EB/OL]. [2025-01-14]. https://www.ohri.ca/programs/clinical_epidemiology/oxford.asp Cited in this article [1]

[10]

Zeng

, Zhang

, Kwong

, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review[J]. J Evid Based Med, 2015, 8(1): 2-10. DOI: 10.1111/jebm.12141 .

https://www.ncbi.nlm.nih.gov/pubmed/25594108

Cited in this article [1]

[11]	Bayley N. Bayley Scales of Infant Development[M]. 2nd ed. San Antonio, TX: The Psychological Corporation, 1993. Cited in this article [1]

[12]

Hack

, Taylor

, Drotar

, et al. Poor predictive validity of the Bayley Scales of Infant Development for cognitive function of extremely low birth weight children at school age[J]. Pediatrics, 2005, 116(2): 333-341. DOI: 10.1542/peds.2005-0173 .

https://www.ncbi.nlm.nih.gov/pubmed/16061586

Cited in this article [1]

[13]	Albers CA, Grieve AJ. Test Review: Bayley, N. (2006). Bayley Scales of Infant and Toddler Development: Third Edition. San Antonio, TX: Harcourt Assessment[J]. J Psychoeduc Assess, 2007, 25(2): 180-190. DOI: 10.1177/0734282906297199 . Cited in this article [1]

[14]	Bayley N. Bayley Scales of Infant and Toddler Development[M]. 3rd ed. San Antonio, TX: Pearson PsychCorp, 2006. Cited in this article [1]

[15]

Provost

, Fourdain

, Vannasing

, et al. Relationship between 4-month functional brain network topology and 24-month neurodevelopmental outcome in children with congenital heart disease[J]. Eur J Paediatr Neurol, 2023, 47: 47-59. DOI: 10.1016/j.ejpn.2023.09.005 .

https://www.ncbi.nlm.nih.gov/pubmed/37729706

Cited in this article [3]

[16]	Na SD, Burns TG. Wechsler Intelligence Scale for Children-V: test review[J]. Appl Neuropsychol Child, 2016, 5(2): 156-160. DOI: 10.1080/21622965.2015.1015337 . https://www.ncbi.nlm.nih.gov/pubmed/25923224 Cited in this article [1]

[17]	Hurks P, Hendriksen J, Dek J, et al. Accuracy of short forms of the Dutch Wechsler Preschool and Primary Scale of Intelligence: third edition[J]. Assessment, 2016, 23(2): 240-249. DOI: 10.1177/1073191115577189 . https://www.ncbi.nlm.nih.gov/pubmed/25804438 Cited in this article [1]

[18]

Speckert

, Payette

, Knirsch

, et al. Altered connectome topology in newborns at risk for cognitive developmental delay: a cross-etiologic study[J]. Hum Brain Mapp, 2025, 46(1): e70084. PMCID: PMC11718324. DOI: 10.1002/hbm.70084 .

https://www.ncbi.nlm.nih.gov/pubmed/39791277

Cited in this article [2]

[19]

Steger

, Feldmann

, Borns

, et al. Neurometabolic changes in neonates with congenital heart defects and their relation to neurodevelopmental outcome[J]. Pediatr Res, 2023, 93(6): 1642-1650. PMCID: PMC10172141. DOI: 10.1038/s41390-022-02253-y .

https://www.ncbi.nlm.nih.gov/pubmed/35995938

Cited in this article [1]

[20]	Sadhwani A, Wypij D, Rofeberg V, et al. Fetal brain volume predicts neurodevelopment in congenital heart disease[J]. Circulation, 2022, 145(15): 1108-1119. PMCID: PMC9007882. DOI: 10.1161/CIRCULATIONAHA.121.056305 . https://www.ncbi.nlm.nih.gov/pubmed/35143287 Cited in this article [1]

[21]	Hottinger SJ, Liamlahi R, Feldmann M, et al. Postoperative improvement of brain maturation in infants with congenital heart disease[J]. Semin Thorac Cardiovasc Surg, 2022, 34(1): 251-259. DOI: 10.1053/j.semtcvs.2020.11.029 . https://www.ncbi.nlm.nih.gov/pubmed/33248231 Cited in this article [1]

[22]	Yoshida T, Hiraiwa A, Ibuki K, et al. Neurodevelopmental outcomes at 3 years for infants with congenital heart disease and very-low birthweight[J]. Pediatr Int, 2020, 62(7): 797-803. DOI: 10.1111/ped.14160 . https://www.ncbi.nlm.nih.gov/pubmed/31957091 Cited in this article [1]

[23]

Meuwly

, Feldmann

, Knirsch

, et al. Postoperative brain volumes are associated with one-year neurodevelopmental outcome in children with severe congenital heart disease[J]. Sci Rep, 2019, 9(1): 10885. PMCID: PMC6659678. DOI: 10.1038/s41598-019-47328-9 .

https://www.ncbi.nlm.nih.gov/pubmed/31350426

Cited in this article [1]

[24]

Goldsworthy

, Franich-Ray

, Kinney

, et al. Relationship between social-emotional and neurodevelopment of 2-year-old children with congenital heart disease[J]. Congenit Heart Dis, 2016, 11(5): 378-385. DOI: 10.1111/chd.12320 .

https://www.ncbi.nlm.nih.gov/pubmed/26680016

Cited in this article [1]

[25]

Hallioglu

, Gurer

, Bozlu

, et al. Evaluation of neurodevelopment using Bayley-III in children with cyanotic or hemodynamically impaired congenital heart disease[J]. Congenit Heart Dis, 2015, 10(6): 537-541. DOI: 10.1111/chd.12269 .

https://www.ncbi.nlm.nih.gov/pubmed/25912000

Cited in this article [1]

[26]	Chen CY, Harrison T, Heathcock J. Infants with complex congenital heart diseases show poor short-term memory in the mobile paradigm at 3 months of age[J]. Infant Behav Dev, 2015, 40: 12-19. DOI: 10.1016/j.infbeh.2015.02.007 . https://www.ncbi.nlm.nih.gov/pubmed/25919428 Cited in this article [1]

[27]	Cheatham SL, Carey H, Chisolm JL, et al. Early results of neurodevelopment following hybrid stage I for hypoplastic left heart syndrome[J]. Pediatr Cardiol, 2015, 36(3): 685-691. DOI: 10.1007/s00246-014-1065-5 . https://www.ncbi.nlm.nih.gov/pubmed/25380966 Cited in this article [2]

[28]	桂娟, 何少茹, 孙云霞, 等. 先天性心脏病小婴儿18月龄时神经发育障碍及影响因素研究[J]. 中华胸心血管外科杂志, 2019, 35(10): 577-582. DOI: 10.3760/cma.j.issn.1001-4497.2019.10.001 . Cited in this article [2]

[29]	钟秀兰. 先天性心脏病婴儿生长及智力发育状况的研究[J]. 饮食保健, 2018, 5(4): 51. DOI: 10.3969/j.issn.2095-8439.2018.04.060 . Cited in this article [1]

[30]	Yilmaz İZ, Erdur B, Ozbek E, et al. Neurodevelopmental evaluation of children with cyanotic congenital heart disease[J]. Minerva Pediatr, 2018, 70(4): 365-370. DOI: 10.23736/S0026-4946.17.04265-7 . https://www.ncbi.nlm.nih.gov/pubmed/26041003 Cited in this article [1]

[31]	Rollins CK, Asaro LA, Akhondi-Asl A, et al. White matter volume predicts language development in congenital heart disease[J]. J Pediatr, 2017, 181: 42-48.e2. PMCID: PMC5274582. DOI: 10.1016/j.jpeds.2016.09.070 . https://www.ncbi.nlm.nih.gov/pubmed/27837950 Cited in this article [1]

[32]	杨望, 温恩懿, 胡斌, 等. 婴幼儿先天性心脏病合并认知及运动功能障碍的临床研究[J]. 第三军医大学学报, 2015, 37(2): 164-166. DOI: 10.16016/j.1000-5404.201408127 . Cited in this article [1]

[33]	Puosi R, Korkman M, Sarajuuri A, et al. Neurocognitive development and behavioral outcome of 2-year-old children with univentricular heart[J]. J Int Neuropsychol Soc, 2011, 17(6): 1094-1103. DOI: 10.1017/S135561771100110X . https://www.ncbi.nlm.nih.gov/pubmed/22014005 Cited in this article [1]

[34]	Matsuzaki T, Matsui M, Ichida F, et al. Neurodevelopment in 1-year-old Japanese infants after congenital heart surgery[J]. Pediatr Int, 2010, 52(3): 420-427. DOI: 10.1111/j.1442-200X.2009.02974.x . https://www.ncbi.nlm.nih.gov/pubmed/19807876 Cited in this article [1]

[35]	Sarajuuri A, Jokinen E, Puosi R, et al. Neurodevelopment in children with hypoplastic left heart syndrome[J]. J Pediatr, 2010, 157(3): 414-420.e4. DOI: 10.1016/j.jpeds.2010.04.027 . https://www.ncbi.nlm.nih.gov/pubmed/20570285 Cited in this article [1]

[36]	Matsuzaki T, Matsui M, Nakazawa J, et al. Application of the Bayley Scales of Infant Development as a developmental test for Japanese infants with congenital heart disease[J]. No To Hattatsu, 2008, 40(4): 308-312. https://www.ncbi.nlm.nih.gov/pubmed/18634416 Cited in this article [1]

[37]

Schultz

, Jarvik

, Wernovsky

, et al. Effect of congenital heart disease on neurodevelopmental outcomes within multiple-gestation births[J]. J Thorac Cardiovasc Surg, 2005, 130(6): 1511-1516. DOI: 10.1016/j.jtcvs.2005.07.040 .

https://www.ncbi.nlm.nih.gov/pubmed/16307991

Cited in this article [2]

[38]	Vasserman M, Myers K, Brooks BL, et al. Patterns of WISC-V performance in children with congenital heart disease[J]. Pediatr Cardiol, 2024, 45(3): 483-490. DOI: 10.1007/s00246-023-03367-8 . https://www.ncbi.nlm.nih.gov/pubmed/38214737 Cited in this article [2]

[39]

Provost

, Fourdain

, Vannasing

, et al. Language brain responses and neurodevelopmental outcome in preschoolers with congenital heart disease: a fNIRS study[J]. Neuropsychologia, 2024, 196: 108843. DOI: 10.1016/j.neuropsychologia.2024.108843 .

https://www.ncbi.nlm.nih.gov/pubmed/38423173

Cited in this article [1]

[40]

, Li

, Liu

, et al. Changes in cortical thickness are associated with cognitive ability in postoperative school-aged children with tetralogy of fallot[J]. Front Neurol, 2020, 11: 691. PMCID: PMC7380078. DOI: 10.3389/fneur.2020.00691 .

https://www.ncbi.nlm.nih.gov/pubmed/32765405

Cited in this article [2]

[41]	Sterken C, Lemiere J, Van den Berghe G, et al. Neurocognitive development after pediatric heart surgery[J]. Pediatrics, 2016, 137(6): e20154675. DOI: 10.1542/peds.2015-4675 . https://www.ncbi.nlm.nih.gov/pubmed/27245833 Cited in this article [1]

[42]	Sarrechia I, Miatton M, François K, et al. Neurodevelopmental outcome after surgery for acyanotic congenital heart disease[J]. Res Dev Disabil, 2015, 45-46: 58-68. DOI: 10.1016/j.ridd.2015.07.004 . https://www.ncbi.nlm.nih.gov/pubmed/26210851 Cited in this article [1]

[43]	Sarrechia I, Miatton M, De Wolf D, et al. Neurobehavioural functioning in school-aged children with a corrected septal heart defect[J]. Acta Cardiol, 2013, 68(1): 23-30. DOI: 10.1080/ac.68.1.2959628 . https://www.ncbi.nlm.nih.gov/pubmed/23457906 Cited in this article [1]

[44]

Schaefer

, von Rhein

, Knirsch

, et al. Neurodevelopmental outcome, psychological adjustment, and quality of life in adolescents with congenital heart disease[J]. Dev Med Child Neurol, 2013, 55(12): 1143-1149. DOI: 10.1111/dmcn.12242 .

https://www.ncbi.nlm.nih.gov/pubmed/23937239

Cited in this article [1]

[45]	管国涛. 经导管介入封堵术或外科手术后室间隔缺损患儿学龄期的认知功能及行为问题[D]. 济南: 山东大学, 2011. Cited in this article [1]

[46]	Miatton M, De Wolf D, François K, et al. Intellectual, neuropsychological, and behavioral functioning in children with tetralogy of Fallot[J]. J Thorac Cardiovasc Surg, 2007, 133(2): 449-455. DOI: 10.1016/j.jtcvs.2006.10.006 . https://www.ncbi.nlm.nih.gov/pubmed/17258582 Cited in this article [1]

[47]	Miatton M, De Wolf D, François K, et al. Neuropsychological performance in school-aged children with surgically corrected congenital heart disease[J]. J Pediatr, 2007, 151(1): 73-78.e1. DOI: 10.1016/j.jpeds.2007.02.020 . https://www.ncbi.nlm.nih.gov/pubmed/17586194 Cited in this article [1]

[48]	Yang LL, Liu ML, Townes BD. Neuropsychological and behavioral status of Chinese children with acyanotic congenital heart disease[J]. Int J Neurosci, 1994, 74(1-4): 109-115. DOI: 10.3109/00207459408987235 . https://www.ncbi.nlm.nih.gov/pubmed/7928100 Cited in this article [1]

[49]	刘美兰, 杨玲玲. 先天性心脏病对儿童智力及行为发育的影响[J]. 中华神经精神科杂志, 1992, 25(3): 160-164. Cited in this article [2]

[50]	Feldmann M, Bataillard C, Ehrler M, et al. Cognitive and executive function in congenital heart disease: a meta-analysis[J]. Pediatrics, 2021, 148(4): e2021050875. DOI: 10.1542/peds.2021-050875 . https://www.ncbi.nlm.nih.gov/pubmed/34561266 Cited in this article [2]

[51]	Howell HB, Zaccario M, Kazmi SH, et al. Neurodevelopmental outcomes of children with congenital heart disease: a review[J]. Curr Probl Pediatr Adolesc Health Care, 2019, 49(10): 100685. DOI: 10.1016/j.cppeds.2019.100685 . https://www.ncbi.nlm.nih.gov/pubmed/31708366 Cited in this article [1]

[52]	Stavinoha PL, Fixler DE, Mahony L. Cardiopulmonary bypass to repair an atrial septal defect does not affect cognitive function in children[J]. Circulation, 2003, 107(21): 2722-2725. DOI: 10.1161/01.CIR.0000070620.97086.65 . https://www.ncbi.nlm.nih.gov/pubmed/12742985 Cited in this article [1]

[53]

Karsdorp

, Everaerd

, Kindt

, et al. Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis[J]. J Pediatr Psychol, 2007, 32(5): 527-541. DOI: 10.1093/jpepsy/jsl047 .

https://www.ncbi.nlm.nih.gov/pubmed/17182669

Cited in this article [2]

[54]	Turner T, El Tobgy N, Russell K, et al. Language abilities in preschool children with critical CHD: a systematic review[J]. Cardiol Young, 2022, 32(5): 683-693. DOI: 10.1017/S1047951122001330 . https://www.ncbi.nlm.nih.gov/pubmed/35510297 Cited in this article [2]

[55]

Sprong

MCA

, Broeders

, van der Net

, et al. Motor developmental delay after cardiac surgery in children with a critical congenital heart defect: a systematic literature review and meta-analysis[J]. Pediatr Phys Ther, 2021, 33(4): 186-197. DOI: 10.1097/PEP.0000000000000827 .

https://www.ncbi.nlm.nih.gov/pubmed/34618742

Cited in this article [2]

[56]

Huisenga

, La Bastide-Van Gemert

, Van Bergen

, et al. Developmental outcomes after early surgery for complex congenital heart disease: a systematic review and meta-analysis[J]. Dev Med Child Neurol, 2021, 63(1): 29-46. PMCID: PMC7754445. DOI: 10.1111/dmcn.14512 .

https://www.ncbi.nlm.nih.gov/pubmed/32149404

Cited in this article [2]

[57]	Snookes SH, Gunn JK, Eldridge BJ, et al. A systematic review of motor and cognitive outcomes after early surgery for congenital heart disease[J]. Pediatrics, 2010, 125(4): e818-e827. DOI: 10.1542/peds.2009-1959 . https://www.ncbi.nlm.nih.gov/pubmed/20231182 Cited in this article [2]

[58]	Mills R, McCusker CG, Tennyson C, et al. Neuropsychological outcomes in CHD beyond childhood: a meta-analysis[J]. Cardiol Young, 2018, 28(3): 421-431. DOI: 10.1017/S104795111700230X . https://www.ncbi.nlm.nih.gov/pubmed/29208070 Cited in this article [1]