Symptoms of communication and social impairment
in toddlers with congenital heart defects
R. E. Brandlistuen,*† K. Stene-Larsen,*† H. Holmstrøm,‡ M. A. Landolt,§ L. T. Eskedal¶
and M. E. Vollrath*†
*Department of Psychosomatics and Health Behavior, Norwegian Institute of Public Health
†Department of Psychology, University of Oslo
‡Department of Pediatrics, Rikshospitalet University Hospital, Oslo
¶Department of Pediatrics, Sørlandet Hospital HF, Kristiansand, Norway, and
§Department of Psychosomatics and Psychiatry, University Children’s Hospital, Zurich, Switzerland
Accepted for publication 9 June 2010
Keywords
CHD severity, child
development,
comorbidity
Correspondence:
Ragnhild Eek
Brandlistuen, Department
of Psychosomatics and
Health Behavior,
Norwegian Institute of
Public Health, Post Box
4404, Nydalen, 0403 Oslo,
Norway
E-mail: ragnhild.eek.
brandlistuen@fhi.no
Abstract
Background With the advances in congenital cardiac surgery and medical management, mortality
rates for congenital heart defects (CHD) have declined remarkably. As the number of CHD survivors
have increased there is a growing focus on developmental morbidity.The objective of the current
study is to compare symptoms of communication and social impairment in 18-month-old children
with different severity of CHD with those of controls.
Method We linked prospective data from the Norwegian Mother and Child Cohort Study,
conducted by the Norwegian Institute of Public Health, with a nationwide medical CHD registry
and identified 198 18-month-olds with CHD in a cohort of 47 692. Three groups of CHD were
distinguished: mild/moderate (n = 122), severe (n = 54) and CHD with comorbidity (n = 22). Mothers
reported on the child’s communication and social skills by completing items from the Ages and
Stages Questionnaire as part of the Norwegian Mother and Child Cohort Study.
Results Children aged 18 months old with CHD differed significantly from controls in levels of
symptoms of communication impairment (P 0.0001) and social impairment (P 0.0001). The
largest differences were found in children with CHD and comorbidity. Children with severe CHD
also showed higher levels of both symptoms of communication and social impairment. Children
with mild/moderate CHD showed a small difference only in symptoms of communication
impairment.
Conclusion Children with severe CHD and CHD with comorbidity show more symptoms of
communication and social impairment compared with a large cohort at the age of 18 months. It is
important to broaden the scope of inquiry to involve communication and social developmental
domains.
Introduction
Every year 0.5%–1% of all infants are born with a congenital
heart defect (CHD) (Hoffman & Kaplan 2002) making
CHD the most common congenital malformations. With
improved survival in the current era, it has become
increasingly evident that neurological and developmental
abnormalities compromise the quality of life in many children
with severe CHD (Hovels-Gurich et al. 2002; Landolt et al.
2008).
Child:
care, health and development
Original Article doi:10.1111/j.1365-2214.2010.01148.x
© 2010 Blackwell Publishing Ltd 37