Department of Neuropsychology, Children's National Hospital, Washington, DC, USA.
Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Cardiol Young. 2023 Apr;33(4):619-626. doi: 10.1017/S1047951122001469. Epub 2022 Sep 12.
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.
与健康对照组相比，患有 CHD 的年轻人患神经发育障碍的风险更高。病因是多因素的，但包括医疗和人口统计学因素。我们试图描述 CHD 患者神经发育障碍的患病率。我们的研究人群包括 206 名年龄在 3-21 岁之间的 CHD 患者，他们因神经心理评估而被转介。神经发育诊断由持牌心理学家确定。将神经发育诊断率与全国患病率进行比较。探索性分析（卡方检验）检查了哪些医疗因素（即心脏诊断、遗传状况、早产、癫痫发作和中风）与神经发育诊断相关。与普通人群相比，CHD 患者神经发育障碍的患病率更高（44%）。注意缺陷多动障碍（27.3%）、自闭症谱系障碍（9.6%）和智力残疾（5.9%）的发病率明显高于普通人群（p<0.01）。有主动脉阻塞病史的儿童更有可能被诊断为自闭症（p<0.05），有遗传疾病的儿童更有可能被诊断为智力残疾（p<0.05）。神经发育诊断与任何其他特定的医疗变量（如心脏诊断、癫痫发作、中风、早产和产前诊断）均无显著相关性。学龄儿童比学龄前儿童更有可能被诊断出任何神经发育障碍和注意缺陷多动障碍（31.7%；p<0.01）。总之，我们的研究结果证实，患有 CHD 的儿童和青少年患神经发育障碍的风险很高，需要持续监测、护理和支持。患有遗传疾病和主动脉阻塞的儿童可能更容易患某些神经发育障碍。
