Arkansas Center for Birth Defects Research and Prevention and the Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #820, Little Rock, AR, 72205-7199, USA.
Department of Biostatistics, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
BMC Pediatr. 2023 Mar 4;23(1):106. doi: 10.1186/s12887-023-03924-3.
Children with congenital heart defects (CHDs) are at higher risk of developing an intellectual disability. However, severity of intellectual disabilities among this group of children are largely unknown. Our objective was to determine the risk of intellectual disability (ID), ID severity, and autism among children with CHDs.
We conducted a retrospective cohort study of singleton live births in Western Australia (n = 20,592) between 1983 and 2010. Children with CHDs were identified from the Western Australian Register for Developmental Anomalies (n = 6563) and infants without CHDs were randomly selected from state birth records (n = 14,029). Children diagnosed with ID before 18 years were identified by linkage to statewide Intellectual Disability Exploring Answers database. Odds ratios (OR) and 95% confidence intervals (CI) were calculated from logistic regression models for all CHDs combined and by CHD severity adjusting for potential confounders.
Of 20,592 children, 466 (7.1%) with CHDs and 187 (1.3%) without CHDs had an ID. Compared to children without CHDs, children with any CHD had 5.26 times (95% CI 4.42, 6.26) the odds of having an ID and 4.76 times (95% CI 3.98, 5.70) the odds of having mild/moderate ID. Children with any CHD had 1.76 times the odds of having autism (95% CI 1.07, 2.88), and 3.27 times the odds of having an unknown cause of ID (95% CI 2.65, 4.05) compared to children without CHD. The risk of having autism (aOR 3.23, 95% CI 1.11, 9.38), and unknown cause of ID (aOR 3.45, 95% CI 2.09, 5.70) was greatest for children with mild CHD.
Children with CHDs were more likely to have an ID or autism. Future research should elucidate underlying etiology of ID in children with CHDs.
患有先天性心脏缺陷（CHD）的儿童发生智力残疾的风险较高。然而，该人群中智力残疾的严重程度在很大程度上尚不清楚。我们的目的是确定患有 CHD 的儿童发生智力残疾（ID）、ID 严重程度和自闭症的风险。
我们对 1983 年至 2010 年间西澳大利亚州的单胎活产儿进行了回顾性队列研究（n=20592）。从西澳大利亚发育异常登记处（n=6563）中确定了患有 CHD 的儿童，从州出生记录中随机选择了没有 CHD 的婴儿（n=14029）。通过与全州智力残疾探索答案数据库的链接，确定了在 18 岁之前被诊断为 ID 的儿童。采用逻辑回归模型计算所有 CHD 合并和按 CHD 严重程度调整后的比值比（OR）和 95%置信区间（CI）。
在 20592 名儿童中，466 名（7.1%）患有 CHD，187 名（1.3%）无 CHD 患有 ID。与无 CHD 的儿童相比，患有任何 CHD 的儿童发生 ID 的可能性高 5.26 倍（95%CI 4.42，6.26），发生轻度/中度 ID 的可能性高 4.76 倍（95%CI 3.98，5.70）。患有任何 CHD 的儿童发生自闭症的可能性高 1.76 倍（95%CI 1.07，2.88），发生 ID 未知原因的可能性高 3.27 倍（95%CI 2.65，4.05）与无 CHD 的儿童相比。患有轻度 CHD 的儿童发生自闭症（aOR 3.23，95%CI 1.11，9.38）和 ID 未知原因（aOR 3.45，95%CI 2.09，5.70）的风险最大。
患有 CHD 的儿童更有可能发生 ID 或自闭症。未来的研究应阐明 CHD 儿童 ID 的潜在病因。
