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Children with Congenital Heart Disease Show Increased Behavioral Problems Compared to Healthy Peers: A Systematic

Grace G Finkel1, Lena S Sun1, William M Jackson2

  • 1Department of Anesthesiology, Columbia University Irving Medical Center, 622 W. 168th St., PH5-505, New York, NY, 10032, USA.

Pediatric Cardiology
|June 6, 2022
PubMed

Insights

Congenital heart disease (CHD) is linked to a small increase in internalizing and total behavioral problems in children and adults. Further research is needed to identify specific risk factors for these behavioral issues in the CHD population.

Area of Science:

  • Cardiology
  • Developmental Psychology
  • Behavioral Science

Background:

  • Congenital heart disease (CHD) affects millions globally, yet behavioral problem risks remain under-researched.
  • A comprehensive meta-analysis was needed to synthesize existing evidence on behavioral issues in individuals with CHD.

Approach:

  • A systematic review and meta-analysis was conducted, searching major databases (PubMed, CINAHL, Embase, PsycInfo, Cochrane Library) from 1986 to 2021.
  • Included 24 studies assessing behavioral problems in individuals aged over 3 years with CHD compared to controls.
  • Analyzed internalizing, externalizing, and total behavior problems using standardized mean differences (SMD).

Key Points:

  • Individuals with CHD showed a small but significant increase in internalizing problems (SMD: 0.198) and total behavior problems (SMD: 0.287).
  • No significant difference in externalizing behavioral problems was observed between groups.
  • Significant heterogeneity was noted across studies, with no clear explanation from analyzed variables like age or CHD severity.

Conclusions:

  • This meta-analysis indicates a heightened risk for internalizing and overall behavioral problems in individuals with CHD.
  • The low quality of evidence and unexplained heterogeneity highlight the need for future research.
  • Future studies should focus on identifying specific risk factors and controlling for potential confounders to better understand and manage behavioral health in the CHD population.

Keywords:
BehavioralCongenitalHeartMeta-analysisProblems

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