Cave Daniel G W, Wands Zoë E, Cromie Kirsten, Hough Amy, Johnson Kathryn, Mon-Williams Mark, Bentham James R, Feltbower Richard G, Glaser Adam W
Leeds Institute for Data Analytics (LIDA), School of Medicine, University of Leeds, Clarendon Way, Leeds, West Yorkshire LS2 9JT, UK.
Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, UK.
Eur Heart J Qual Care Clin Outcomes. 2024 Aug 8;10(5):456-466. doi: 10.1093/ehjqcco/qcad068.
Educational attainment in children with congenital heart disease (CHD) within the UK has not been reported, despite the possibility of school absences and disease-specific factors creating educational barriers.
Children were prospectively recruited to the Born in Bradford birth cohort between March 2007 and December 2010. Diagnoses of CHD were identified through linkage to the congenital anomaly register and independently verified by clinicians. Multivariable regression accounted for relevant confounders. Our primary outcome was the odds of 'below expected' attainment in maths, reading, and writing at ages 4-11 years.Educational records of 139 children with non-genetic CHD were compared with 11 188 age-matched children with no major congenital anomaly. Children with CHD had significantly higher odds of 'below expected' attainment in maths at age 4-5 years [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.07-2.52], age 6-7 (OR 2.03, 95% CI 1.32-3.12), and age 10-11 (OR 2.28, 95% CI 1.01-5.14). Odds worsened with age, with similar results for reading and writing. The odds of receiving special educational needs support reduced with age for children with CHD relative to controls [age 4-5: OR 4.84 (2.06-11.40); age 6-7: OR 3.65 (2.41-5.53); age 10-11: OR 2.73 (1.84-4.06)]. Attainment was similar for children with and without exposure to cardio-pulmonary bypass. Lower attainment was strongly associated with the number of pre-school hospital admissions.
Children with CHD have lower educational attainment compared with their peers. Deficits are evident from school entry and increase throughout primary school.
尽管先天性心脏病（CHD）患儿可能因缺课和疾病特异性因素而面临教育障碍，但英国尚未有关于此类患儿教育程度的报道。
在2007年3月至2010年12月期间，前瞻性招募了出生在布拉德福德的队列研究中的儿童。通过与先天性异常登记册的关联确定CHD诊断，并由临床医生独立核实。多变量回归分析考虑了相关混杂因素。我们的主要结局是4至11岁儿童在数学、阅读和写作方面“低于预期”成绩的几率。将139名非遗传性CHD患儿的教育记录与11188名年龄匹配的无重大先天性异常的儿童进行比较。CHD患儿在4至5岁（优势比[OR]1.64，95%置信区间[CI]1.07 - 2.52）、6至7岁（OR 2.03，95% CI 1.32 - 3.12）和10至11岁（OR 2.28，95% CI 1.01 - 5.14）时数学“低于预期”成绩的几率显著更高。随着年龄增长，几率恶化，阅读和写作方面也有类似结果。与对照组相比，CHD患儿接受特殊教育需求支持的几率随年龄降低[4至5岁：OR 4.84（2.06 - 11.40）；6至7岁：OR 3.65（2.41 - 5.53）；10至11岁：OR 2.73（1.84 - 4.06）]。接受体外循环和未接受体外循环的患儿成绩相似。成绩较低与学前住院次数密切相关。
与同龄人相比，CHD患儿的教育程度较低。从入学时就明显存在不足，且在整个小学阶段不断增加。
