Department of Psychology, University of Miami, Coral Gables, Florida, USA.
School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China.
Birth Defects Res. 2023 Nov 1;115(18):1708-1722. doi: 10.1002/bdr2.2246. Epub 2023 Sep 8.
This study examined risk for developmental disabilities in preschool-aged children with a congenital heart defect (CHD) at the population level.
Statewide birth, birth defects, and preschool developmental disability records were integrated. The final sample included 1,966,585 children (51.0% male). Children were grouped by type(s) of CHD: critical CHD, noncritical CHD, atrial septal defect, or no major birth defects (groups were mutually exclusive).
Children with a CHD (any type) were at increased risk for developmental disability (any type) (RR 2.08, 95% CI 2.03-2.14, P < .001). Children in the critical CHD, noncritical CHD, and atrial septal defect groups were at increased risk for developmental delay, intellectual disability, language impairment, other health impairment, and any disability. Children in the atrial septal defect group were at increased risk for autism spectrum disorder and speech impairment. For all CHD groups, risk was greatest for other health impairment and intellectual disability.
Increased risk for developmental disabilities was identified for children with less severe CHDs as well as for children with more severe (critical) CHDs. All children with CHDs should be closely monitored so that appropriate interventions can be initiated as early as possible to maximize learning outcomes.
本研究在人群水平上检查了患有先天性心脏病 (CHD) 的学龄前儿童发育障碍的风险。
整合了全州范围内的出生、出生缺陷和学龄前发育障碍记录。最终样本包括 1966585 名儿童(51.0%为男性)。根据 CHD 的类型将儿童分为:重症 CHD、非重症 CHD、房间隔缺损或无重大出生缺陷(各组相互排斥)。
患有 CHD(任何类型)的儿童发育障碍(任何类型)的风险增加(RR 2.08,95%CI 2.03-2.14,P<.001)。重症 CHD、非重症 CHD 和房间隔缺损组的儿童发育迟缓、智力残疾、语言障碍、其他健康障碍和任何残疾的风险增加。房间隔缺损组的儿童患自闭症谱系障碍和言语障碍的风险增加。对于所有 CHD 组,其他健康障碍和智力残疾的风险最高。
患有较轻 CHD 的儿童以及患有较重(重症)CHD 的儿童发育障碍的风险增加。所有患有 CHD 的儿童都应密切监测,以便尽早开始进行适当的干预,从而最大限度地提高学习成果。