Impaired Motor Function? Young Children with CHD in Contrast to Adolescents better than Expected in a Direct Twin Comparison

Background: Newborns and infants with congenital heart defect (CHD) often show delayed neurodevelopment. It seems obvious that the operations and treatments of the heart defect, especially on motor skills, are responsible for this delay. It is unclear how the children will develop in the future and how they would have developed without the CHD. Therefore, we compared motor function of twin siblings with and without CHD.

Method: Motor function was measured as part of the nationwide ongoing twin study “SameSame,” investigating neurodevelopment (cognitive function, motor function, mental health, and health related quality of live). Forty-four pairs of twins (one with CHD and the other without, 50 girls [56.8%], 8.94 ± 4.3 years) have completed the Movement Assessment Battery for Children-II so far. The different age groups (A: 3–6 years, n = 32; B: 7–10 years, n = 28; and C: 11–16 years, n = 28) consist of eight age-specific tasks covering the areas of manual dexterity, ball skills, and static and dynamic balance, as well as a total motor score. The data of the twin siblings among each other were compared using the Student t-test for paired samples.

Results: Children with CHD (11.4% simple/38.6% moderate/50% complex CHD severity) showed significantly reduced scores in manual dexterity with a mean difference (MD) of 3.3 points (p = 0.014), in static and dynamic balance (MD = 3.5 points, p = 0.001) and total motor score (MD = 7.7 points, p = 0.004) in the direct comparison with their healthy twin. Regarding the different age groups, the youngest group A showed a significant difference in ball skills (MD = 4.3 points, p = 0.024), group B showed a significant difference in manual dexterity (MD = 5.4 points, p = 0.032) and group C in manual dexterity (MD = 4.3 points, p = 0.030), ball skills (MD = 4.2 points, p = 0.026), static and dynamic balance (MD = 3.6 points, p = 0.047), as well as a total motor score (MD = 12.1 points, p = 0.002) in the burden on children with CHD.

Conclusion: Children and especially adolescents with CHD show deficits in motor function compared with their healthy twin siblings. Children with CHD aged 3 to 10 years show deficits only in one motor function area, in contrast to adolescents who show clear deficits in all motor function areas. This in turn demonstrates that patients with CHD need life-long support and assistance to avoid or compensate for such performance deficits, as well as to be supported to lead an active life.

Publication History

Article published online:
12 February 2022