Neurodevelopmental risk in a referred sample of hospitalized children with congenital heart disease: interrelation between communication and feeding vulnerabilities.
- 1Department of Physical Therapy, Speech-Language Pathology and Occupational Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
- 2Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil.
- 3Department of Physical Therapy, Speech-Language Pathology and Occupational Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil. Electronic address: [email protected].
Abstract
Objective
To determine the prevalence of communication developmental risk in hospitalized children with Congenital Heart Disease (CHD) and to identify clinical, surgical, and hospitalization-related factors independently associated with increased risk.Methods
This cross-sectional observational study was conducted at a tertiary pediatric cardiac center between September 2024 and April 2025. Sixty-five children referred for speech-language pathology assessment underwent communication development screening using a structured developmental observation protocol. Functional feeding status was assessed using the Pediatric Functional Oral Intake Scale. Multivariable logistic regression was used to identify factors independently associated with communication developmental risk, with Firth's penalized logistic regression performed as a sensitivity analysis given the low events-per-variable ratio.Results
Twenty-five children (38%) were classified as being at risk for delayed communication development. Hospitalization in a ward setting, compared with intensive care, was independently associated with lower odds of risk classification (adjusted OR = 0.13, 95% CI 0.02‒0.77, p = 0.025), an association confirmed by the Firth sensitivity analysis (adjusted OR = 0.18, 95% CI 0.03‒0.80, p = 0.024). Length of hospital stay, cyanotic physiology, cardiopulmonary bypass duration, and aortic cross-clamp time were not independently associated with risk. Children classified as at risk also showed significantly greater feeding restrictions.Conclusion
Communication developmental risk was common among hospitalized children with CHD. Hospitalization setting and feeding performance, rather than traditional markers of clinical severity, were associated with communication risk, suggesting a multifactorial model that integrates biological, functional, and environmental factors. These findings suggest that feeding function, alongside hospitalization setting, may help flag children at higher developmental risk before formal communication assessment is available. These exploratory findings support incorporating structured developmental surveillance into routine pediatric cardiac care.
Related
- Resting-State Functional Brain Connectivity and Neurodevelopmental Profiles in 3-Year-Olds with Congenital Heart Disease
- Neurodevelopmental outcome in children with congenital cytomegalovirus infection: a systematic review and meta-analysis protocol
- Clinical and multi-omics characterisation of early neurodevelopmental disorders associated with critical congenital heart disease: the prospective cohort CATAMARAN neonatal study protocol
- Communication Profiles in School-Age Children with Congenital Blindness: A Matched Comparison Study
- Beyond illness severity: transdiagnostic cognitive vulnerabilities as independent predictors of psychological distress in parents of children with rare genetic disorders
BibTeX
@article{pimentelpiemonte2026neurodevelopmental,
title = {{Neurodevelopmental risk in a referred sample of hospitalized children with congenital heart disease: interrelation between communication and feeding vulnerabilities.}},
author = {Camila Pimentel-Piemonte and Fernanda Chiarion Sassi and Ana Paula Ritto and Gisele Chagas de Medeiros and Claudia Regina Furquim de Andrade},
journal = {Clinics (Sao Paulo, Brazil)},
year = {2026},
month = oct,
doi = {10.1016/j.clinsp.2026.101199},
url = {https://europepmc.org/article/MED/42874506},
note = {CC BY},
}
RIS
TY - JOUR
TI - Neurodevelopmental risk in a referred sample of hospitalized children with congenital heart disease: interrelation between communication and feeding vulnerabilities.
AU - Camila Pimentel-Piemonte
AU - Fernanda Chiarion Sassi
AU - Ana Paula Ritto
AU - Gisele Chagas de Medeiros
AU - Claudia Regina Furquim de Andrade
PY - 2026
DA - 2026/10/14
JO - Clinics (Sao Paulo, Brazil)
DO - 10.1016/j.clinsp.2026.101199
UR - https://europepmc.org/article/MED/42874506
AB - Objective To determine the prevalence of communication developmental risk in hospitalized children with Congenital Heart Disease (CHD) and to identify clinical, surgical, and hospitalization-related factors independently associated with increased risk.Methods This cross-sectional observational study was conducted at a tertiary pediatric cardiac center between September 2024 and April 2025. Sixty-five children referred for speech-language pathology assessment underwent communication development screening using a structured developmental observation protocol. Functional feeding status was assessed using the Pediatric Functional Oral Intake Scale. Multivariable logistic regression was used to identify factors independently associated with communication developmental risk, with Firth's penalized logistic regression performed as a sensitivity analysis given the low events-per-variable ratio.Results Twenty-five children (38%) were classified as being at risk for delayed communication development. Hospitalization in a ward setting, compared with intensive care, was independently associated with lower odds of risk classification (adjusted OR = 0.13, 95% CI 0.02‒0.77, p = 0.025), an association confirmed by the Firth sensitivity analysis (adjusted OR = 0.18, 95% CI 0.03‒0.80, p = 0.024). Length of hospital stay, cyanotic physiology, cardiopulmonary bypass duration, and aortic cross-clamp time were not independently associated with risk. Children classified as at risk also showed significantly greater feeding restrictions.Conclusion Communication developmental risk was common among hospitalized children with CHD. Hospitalization setting and feeding performance, rather than traditional markers of clinical severity, were associated with communication risk, suggesting a multifactorial model that integrates biological, functional, and environmental factors. These findings suggest that feeding function, alongside hospitalization setting, may help flag children at higher developmental risk before formal communication assessment is available. These exploratory findings support incorporating structured developmental surveillance into routine pediatric cardiac care.
SN - 1807-5932
SN - 1980-5322
ER -