{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T02:14:11Z","timestamp":1793844851771,"version":"4.6.1"},"reference-count":146,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>CONTEXT<\/jats:title>\n                    <jats:p>Cognitive function and executive function (EF) impairments contribute to the long-term burden of congenital heart disease (CHD). However, the degree and profile of impairments are insufficiently described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To systematically review and meta-analyze the evidence on cognitive function and EF outcomes in school-aged children operated for CHD and identify the risk factors for an unfavorable outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA SOURCES<\/jats:title>\n                    <jats:p>Cochrane, Embase, Medline, and PsycINFO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY SELECTION<\/jats:title>\n                    <jats:p>Original peer-reviewed studies reporting cognitive or EF outcome in 5- to 17-year old children with CHD after cardiopulmonary bypass surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DATA EXTRACTION<\/jats:title>\n                    <jats:p>Results of IQ and EF assessments were extracted, and estimates were transformed to means and SE. Standardized mean differences were calculated for comparison with healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Among 74 studies (3645 children with CHD) reporting total IQ, the summary estimate was 96.03 (95% confidence interval: 94.91 to 97.14). Hypoplastic left heart syndrome and univentricular CHD cohorts performed significantly worse than atrial and ventricular septum defect cohorts (P = .0003; P = .027). An older age at assessment was associated with lower IQ scores in cohorts with transposition of the great arteries (P = .014). Among 13 studies (774 children with CHD) reporting EF compared with controls, the standardized mean difference was \u22120.56 (95% confidence interval: \u22120.65 to \u22120.46) with no predilection for a specific EF domain or age effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS<\/jats:title>\n                    <jats:p>Heterogeneity between studies was large.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Intellectual impairments in CHD are frequent, with severity and trajectory depending on the CHD subtype. EF performance is poorer in children with CHD without a specific EF profile. The heterogeneity in studied populations and applied assessments is large. A uniform testing guideline is urgently needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2021-050875","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T04:37:19Z","timestamp":1632458239000},"source":"Crossref","is-referenced-by-count":131,"title":["Cognitive and Executive Function in Congenital Heart Disease: A Meta-analysis"],"prefix":"10.1542","volume":"148","author":[{"given":"Maria","family":"Feldmann","sequence":"first","affiliation":[{"name":"Child Development Centre and Children\u2019s Research Centre"},{"name":"Children's Research Centre, University Children\u2019s Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9lina","family":"Bataillard","sequence":"additional","affiliation":[{"name":"Child Development Centre and Children\u2019s Research Centre"},{"name":"Children's Research Centre, University Children\u2019s Hospital Zurich, Zurich, 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