More than one-third of the children with a history of congenital heart disease (CHD) are diagnosed with or treated for neurodevelopmental or mental health conditions, according to a population-based cohort study.

Researchers aimed to identify clinical and socioeconomic factors associated with four common diagnostic categories, i.e., developmental disorders, intellectual disability, attention-deficit/hyperactivity disorder (ADHD), and anxiety or mood disorders. The findings of the analysis were published in Circulation: Cardiovascular Quality and Outcomes.

The study analyzed data from 16,473 children under 18 years diagnosed with CHD between 1996 and 2017. Children who had already been diagnosed with a neurodevelopmental or mental health condition before their CHD diagnosis were excluded. The data were collected by linking health and social registries and calculating cumulative incidence rates, incidence rates, and hazard ratios, both crude and adjusted. The adjustments included variables such as child sex, year of CHD diagnosis, and complexity of CHD.

By age 18, the cumulative incidence of developmental disorders was 7.5%, intellectual disability 5.0%, ADHD 5.8%, and anxiety or mood disorders 10.3%. The most significant clinical predictor across all these conditions was the number of days spent in the hospital within the initial year after CHD diagnosis. Additional predictors included being born small for gestational age, having a genetic syndrome, and sex.

Low parental education (9–10 years), maternal or paternal age below 25, unemployment, and maternal marital status (being single or divorced) were associated with increased risks of ADHD and intellectual disability. Maternal and paternal mental health diagnoses predict all four neurodevelopmental and mental health diagnostic categories in children.