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Prevalence of neurodevelopmental disorders in a clinically referred sample of children with CHD
Hayley J Loblein1,2,3, Patrick W Vukmirovich1, Mary T Donofrio2,4
1Department of Neuropsychology, Children's National Hospital, Washington, DC, USA.
Insights
Children with congenital heart disease (CHD) have a significantly higher risk of neurodevelopmental disorders, including ADHD and autism. Specific conditions like genetic disorders and aortic obstruction increase this risk, necessitating close monitoring.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Disorders
- Congenital Heart Disease (CHD)
Background:
- Youth with congenital heart disease (CHD) exhibit increased vulnerability to neurodevelopmental disorders compared to healthy peers.
- The etiology of these disorders is multifactorial, influenced by both medical and demographic factors.
Purpose of the Study:
- To characterize the prevalence of neurodevelopmental disorders in pediatric patients diagnosed with CHD.
- To compare neurodevelopmental disorder rates in CHD patients with national prevalence data.
- To explore associations between specific medical factors and neurodevelopmental diagnoses in this population.
Main Methods:
- A cohort of 206 patients aged 3-21 with CHD, referred for neuropsychological evaluation, was studied.
- Neurodevelopmental diagnoses were established by a licensed psychologist.
- Chi-square analyses examined the relationship between medical factors (e.g., cardiac diagnosis, genetic condition, prematurity, seizures, stroke) and neurodevelopmental diagnoses.
Main Results:
- A high prevalence of neurodevelopmental disorders (44%) was observed in the CHD population, significantly exceeding general population rates (p < .01).
- Specific diagnoses were elevated: attention-deficit/hyperactivity disorder (27.3%), autism spectrum disorder (9.6%), and intellectual disability (5.9%).
- Children with a history of aortic obstruction showed higher autism rates, while those with genetic conditions had increased intellectual disability diagnoses (p < .05). School-aged children were more prone to neurodevelopmental disorders and ADHD.
Conclusions:
- Children and adolescents with CHD face a substantially elevated risk for neurodevelopmental disorders, underscoring the need for continuous monitoring and support.
- Certain medical factors, specifically genetic conditions and aortic obstruction, are associated with a higher likelihood of specific neurodevelopmental disorders in CHD patients.
- These findings highlight critical areas for targeted interventions and specialized care pathways for pediatric populations with congenital heart disease.
Abstract:
Youth with CHD are at greater risk for neurodevelopmental disorders compared to healthy controls. The aetiology is multi-factorial but includes medical and demographic factors. We sought to characterise the prevalence of neurodevelopmental disorders in patients with CHD. Our population included 206 patients with CHD, aged 3-21, who were referred for neuropsychological evaluation. Neurodevelopmental diagnoses were determined by a licensed psychologist. Rates of neurodevelopmental diagnoses were compared to national prevalence rates. Exploratory analyses (chi-square) examined which medical factors (i.e., cardiac diagnosis, genetic condition, prematurity, seizures, and stroke) were associated with neurodevelopmental diagnosis. There was higher prevalence of neurodevelopmental disorders in CHD when compared to the general population (44%). Rates of attention-deficit/hyperactivity disorder (27.3%), autism spectrum disorder (9.6%), and intellectual disability (5.9%) were notably higher than those seen in the general population (p < .01). Children with a history of aortic obstruction were more likely to be diagnosed with autism (p < .05), and children with genetic conditions were more likely to be diagnosed with an intellectual disability (p < .05). Neurodevelopmental diagnoses were not significantly associated with any other specific medical variables (e.g., cardiac diagnosis, seizures, stroke, prematurity, and antenatal diagnosis). School-aged children were more likely to be diagnosed with any neurodevelopmental disorder and attention-deficit/hyperactivity disorder (31.7%; p < .01) than preschool-age children. In summary, our results confirm that children and adolescents with CHD are at high risk for neurodevelopmental disorders and require ongoing monitoring, care, and support. Children with genetic disorders and those with aortic obstruction may be more at risk for certain neurodevelopmental disorders.
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