Monday, August 17, 2015

Getting the Right Beat: How Do Children with Congenital Heart Disease Do in School?

By: Joann Schulte  DO, MPH; Editorial Board Member   

         You want to get to the heart of the matter when a neonate has a  murmur or cyanosis.   About 1% of US infants are born with congenital heart disease (CHD) and their lives after discharge can be complicated with follow-up care.  But what happens when such children start school?  How do they  compare to other children?
            A new study published this month in Pediatrics from Riehle-Colarusso et al. (doi: 10.1542/peds.2015-0259) explores that issue with an innovative linkage of three databases to provide a picture about how such children do when school starts.  (This last sentence is the punch line and you state it below—so would not state it here.)
            The authors, epidemiologists from the Centers for Diseases Control and a cardiologist from Emory University, used data from Georgia birth certificates, the Atlanta Congenital Defects Program (population-based surveillance of birth defects) and the Special Education Database of Metropolitan Atlanta to study 3,744 children with CHD.  They tracked a cohort of children born during a 22-year period (1982 to 2004) and compared them to a group of children without major birth defects.
            Only children with isolated CHD, not including children whose conditions was complicated by other genetic diseases or birth defects were included in the study..  The comparison group of 860,715 children was identified through Georgia birth certificates. 
            The authors followed the entire group of 864,459 children to determine if they required special education between 1992 and 2012, using the database that tracked receipt of such services.  The special education database covers nine public school districts in the five counties that make up the metro Atlanta area.  
            The results of this study indicate that 15% of the children with CHD had received special education service compared to 9% of those without birth defects. Compared to the children without birth defects, those with CHD had a higher prevalence of intellectual disability, sensory impairment, and significant developmental delay among other neurodevelopmental impairments..
              This study has implications for what kind of care and follow-up attention might be needed for children with CHD.   Since 2011, screening for congenital heart disease has been recommended through pulse oximetry screening after 24 hours of age and before discharge.  This study suggests that pediatricians taking care of children with congenital heart disease might do well to track the developmental progress of those children.  Early identification of children with special education needs can help their success in school.  Examining twenty-two years’ worth of data for a group of Atlanta children with and without CHD provides important information on neurodevelopmental outcomes that can benefit the entire pediatric population with congenital heart disease..

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1 comment:

  1. Thank you for such a well written It’s full of insightful information and entertaining descriptions. Your point of view is the best among many.
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