FREQUENCY OF PHYSICAL AND NEUROPSYCHOLOGICAL DEVELOPMENTAL DISORDERS IN INFANTS WITH CONGENITAL SEPTAL HEART DEFECTS

Аннотация

In recent years, there has been a significant increase in congenital septal heart defects in children, despite major advancements in medicine. Congenital septal heart defects are characterized not only by impaired cardiac hemodynamics but also by their negative impact on the normal physical development of the child. Unstable cerebral hemodynamics also adversely affects neuropsychological development. A comprehensive approach to the treatment of congenital septal heart defects should include not only the correction of hemodynamic disturbances but also the management of physical and neuropsychological developmental issues. This article presents not only the clinical features of congenital septal heart defects in infants during their first year of life but also describes the nature of physical and neuropsychological developmental disorders in thisgroup ofchildren. Key words: Congenital heart defects, cardiac hemodynamics, physical development, neuropsychic development, ventricular septal defect, atrial septal defect. Relevance. Among cardiovascular diseases in children, congenital heart defects (CHDs) occupy a leading position, with their formation beginning during the embryogenesis stage [5,6,8]. Despite many years of research, this issue remains highly relevant, as CHDs continue to be a major cause of morbidity and mortality in the pediatric population, and many aspects of their pathogenesis and management remain unresolved [3,8]. Currently, the term “congenital heart defects” is interpreted broadly, as CHDs are considered anatomical abnormalities of the heart or great vessels that develop in utero, regardless of thetime at which they are diagnosed [1,4]. Moreover, a further increase in the incidence of congenital heart anomalies is anticipated, possibly due to advancements in diagnostic techniques and improvements inimaging technology [7,8]. Among the wide spectrum of congenital heart defects (CHDs), the most common forms diagnosed during infancy are septal defects, specifically ventricular septal defect (VSD) and atrial septal defect (ASD), which together account for approximately one-third of all congenital heart anomalies [1,7,10]. The hemodynamic disturbances associated with these defects are primarily due to left-to-right shunting, which sequentially leads to volume overload—initially of the left, and subsequently of the right ventricle—followed by pulmonary hypercirculation and the eventual development of pulmonary hypertension. The end stage ofthis cascade is heart failure, which can result in severe, andin somecases irreversible, consequences [1,2,3]. The hemodynamic alterations seen in ASD, and especially in VSD, have a detrimental effect on a child’s health, particularly during early childhood—a critical period for the formation of adaptive mechanisms to environmental conditions, as well as for the development of physical andneuropsychological health [3,7,9]. Hypoxic disorders resulting from congenital septal defects lead to multiorgan dysfunction, exacerbate an already compromised perinatal background, and represent one of the main causes https://ijmri.de/index.php/jmsi volume 4,issue5,2025 1042 ofimpaired physical and neuropsychological development inthis category ofchildren [2,4,10]. Objective. To determine the frequency of hemodynamic disturbances in infants with congenital septal defects during the first year of life and to assess their impact on physical and neuropsychological status. Materials and methods.The study was conducted at the Regional Children's Multidisciplinary Medical Center in Andijan. A total of 50 children under the age of one year with congenital septal heart defects were observed. The majority of cases involved ventricular septal defect (VSD), accounting for 84% (n=42). Atrial septal defect (ASD) was identified in16%of thecases (n=8). In terms of gender distribution, girls predominated among children with VSD (n=25), while boys were morefrequently affected byASD(n=6). Figure 1.Gender distribution ofchildren with septal defects. A comprehensive diagnostic approach was employed in the course of the study. Particular attention was paid to the course ofthe ante- and perinatal periods inthemothers, as well as to the development of motor and neuropsychological functions in each child during the first year of life. Central nervous system damage was assessed based ontheresults of neurosonography (NSG). The evaluation of the cardiovascular system included not only standard physical examination methods but also data from electrocardiography (ECG) and two-dimensional echocardiography (2DEchoCG) with Dopplerimaging todetect pulmonary hypertension. Assessment of physical development was based on the WHO (2014) guidelines "Growth and development of children under five years of age", using anthropometric indicators such as body length and weight. Research Results. Analysis of maternal risk factors revealed that the majority of children were exposed to a combination of two or more adverse