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Congenital heart defects linked to worse academic outcomes in children
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Children with critical and noncritical congenital heart defects experience worse academic outcomes compared with peers, according to data published in Circulation: Cardiovascular Quality and Outcomes.
“In this study, the largest of its kind to study educational outcomes in children with [congenital heart disease], we found that children with [congenital heart disease] have poorer performance on end-of-grade testing in reading and math in the third grade and have higher receipt of exceptional services,” Matthew E. Oster, MD, MPH, pediatric cardiologist at Children’s Healthcare of Atlanta, and colleagues wrote. “Interestingly, this poorer performance in reading and math was seen in both the critical and noncritical [congenital heart disease] cohorts, yet children with noncritical [congenital heart disease] were less likely to receive exceptional services than those with critical [congenital heart disease].”
Oster and colleagues analyzed data of third-graders from North Carolina with congenital heart defects (n = 2,807) and no structural birth defects (n = 6,355) who were born from 1998 to 2003. Third-grade performance was selected for this study, as that is when North Carolina starts administering standardized tests for mathematics and reading. The congenital heart defects most commonly found in children within the cohort were atrial septal defect (55.4%) and ventricular septal defect (47.3%).
The researchers discovered that 44.6% of third-graders with congenital heart defects did not meet standards for math and/or reading vs. 37.5% of children without structural birth defects. The students with congenital heart defects had a greater tendency to seek exceptional services (20.5%) compared with students without congenital heart defects (12.5%).
Among children with congenital heart defects, 463 (16.5%) had critical conditions, whereas 2,344 children had noncritical ones. Both groups of children with congenital heart defects were more likely to not meet reading and math standards than children without structural birth defects (adjusted OR for critical group = 1.43, 95% CI, 1.17-1.76; adjusted OR for noncritical group = 1.2; 95% CI, 1.08-1.34), Oster and colleagues found.
However, according to the researchers, children with critical heart defects were more likely to receive exceptional services than children with noncritical heart defects (adjusted OR = 1.46; 95% CI, 1.15-1.86).
Individuals with congenital heart defects were also analyzed for further structural birth defects and their performance. Of the children with congenital heart defects, 21.1% were born with other noncardiac defects. Those with congenital heart defects and further structural birth defects were more likely to be held back in the third grade than children with no known structural birth defects. Children with only congenital heart defects were not more likely to be kept in third grade than those without known birth defects.
“Parents and providers of children with all types of [congenital heart disease] should be cognizant of the academic obstacles these children may face and should consider evaluations for exceptional services,” Oster and colleagues wrote. – by Darlene Dobkowski
Disclosure: The researchers report no relevant financial disclosures.
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