Congenital Heart Defects and Developmental and Other Psychiatric Disorders

Olsen, Morten; Sørensen, Henrik Toft; Hjortdal, Vibeke E.; Christensen, Thomas; Pedersen, Lars

doi:10.1161/circulationaha.110.002832

Cited by 46 publications

(38 citation statements)

References 44 publications

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“…Our findings extend the knowledge of long-term neurological impairment and mental health functional morbidities in the population with CHD. Although previous studies have reported elevated risks of adverse neurodevelopmental outcomes among individuals with CHD, including increased occurrence of depression, autism, and epilepsy compared with the general population, [6][7][8]19,[32][33][34][35] our study examined an older adult population to determine the later-life consequences of this neurological outcome. Although the underlying pathophysiological mechanisms are not completely understood, the potential etiologic factors appear multifactorial and consistent with previous findings within the neurodevelopmental scientific literature.…”

Section: Discussionmentioning

confidence: 99%

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Risk of Dementia in Adults With Congenital Heart Disease

Bagge¹,

Henderson

Laursen³

et al. 2018

Circulation

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Editorial, see p XXXBACKGROUND: More children with congenital heart disease (CHD) are surviving to adulthood, and CHD is associated with risk factors for dementia. We compared the risk of dementia in CHD adults to that of the general population. METHODS:In this cohort study, we used medical registries and a medical record review covering all Danish hospitals to identify adults with CHD diagnosed between 1963 and 2012. These individuals with CHD were followed from January 1, 1981, 30 years of age, or date of first CHD registration (index date for matched members of the general population cohort) until hospital diagnosis of dementia, death, emigration, or end of study (December 31, 2012). For each individual with CHD, we identified 10 members of the general population utilizing the Danish Civil Registration System matched on sex and birth year. We computed cumulative incidences and hazard ratios (HRs) of dementia, adjusting for sex and birth year. RESULTS:The cumulative incidence of dementia was 4% by 80 years of age in 10 632 adults with CHD (46% male). The overall HR comparing adults with CHD with the general population cohort was 1.6 (95% confidence interval [CI], 1.3−2.0). The HR among individuals with CHD without extracardiac defects was 1.4 (95% CI, 1.1−1.8). Adults with mild-to-moderate CHD had an HR of 1.5 (95% CI, 1.1−2.0), whereas the HR was 2.0 (95% CI, 1.2−3.3) for severe CHD, including univentricular hearts. The HR for early onset dementia (<65 years of age) was 2.6 (95% CI, 1.8−3.8), whereas the late-onset HR was 1.3 (95% CI, 1.0−1.8).CONCLUSIONS: CHD was associated with an increased risk of dementia compared with the general population, in particular for early onset dementia. Further understanding of dementia risk in the population with CHD is a potential target for future investigation.

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Section: Discussionmentioning

confidence: 99%

“…4,5 Neurodevelopmental deficits among infants and children with CHD are well described. [6][7][8] However, research on long-term neurological outcomes in adults with CHD is more limited. Dementia is among the most important late-life neurological diseases in the general population.…”

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confidence: 99%

Risk of Dementia in Adults With Congenital Heart Disease

Bagge¹,

Henderson

Laursen³

et al. 2018

Circulation

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“…In accordance with previous studies, unspecific codes of CHD, codes not related to CHD, and codes of nonstructural CHD were not categorized as CHD. 25,26 Furthermore, isolated bicuspid aortic valve, isolated patent ductus arteriosus, aortic insufficiency, mitral insufficiency, and minor atrial septal defects, including persistent foramen ovale, were not categorized as CHD. The use of the diagnoses has been validated previously.…”

Section: Congenital Heart Defectsmentioning

confidence: 99%

Congenital Heart Defects and Indices of Fetal Cerebral Growth in a Nationwide Cohort of 924 422 Liveborn Infants

et al. 2016

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Background— Neurodevelopmental disorders are the most common and distressful comorbidities associated with congenital heart defects (CHD). Head circumference at birth (HC), a proxy for prenatal cerebral growth, is an established risk factor for neurodevelopmental disorders. Methods and Results— In a nationwide cohort, we included all 924 422 liveborn Danish singletons, 1997 to 2011. CHD was present in 5519. The association between CHD and growth indices was analyzed by multivariable linear regression, adjusted for potential confounders. We report mean differences in gestational age–specific z scores in comparison with the general population. CHD was associated with lower HC z scores, –0.10 (95% confidence interval [CI], –0.13 to –0.08). Several CHD subtypes were associated with smaller HC, eg, hypoplastic left heart syndrome, –0.39 (95% CI, –0.58 to –0.21); common arterial trunk, –0.41 (95% CI, –0.74 to –0.09); and major ventricular septal defects, –0.25 (95% CI, –0.35 to –0.15). Other single-ventricle defects, transposition of the great arteries, tetralogy of Fallot, and anomalous pulmonary venous return, were also associated with smaller HC. Transposition of the great arteries was associated with smaller HC relative to birth weight, –0.26 (95% CI, –0.39 to –0.13). Major ventricular septal defects were associated with larger HC relative to birth weight. The results were consistent under various conditions, eg, when siblings of infants with CHD (n=5311) or infants with other major malformations (n=24 974) were used as the reference. Conclusions— Several subtypes of CHD were associated with smaller HC. The associations with major ventricular septal defects, common arterial trunk, and anomalous pulmonary venous return have not previously been described. Only infants with transposition of the great arteries had smaller HC relative to birth weight.

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“…This register has been shown previously to be a reliable and valid source for identifying congenital heart disease malformations, [10][11][12][13] and it has been used extensively in clinical epidemiological studies of congenital heart defects. [14][15][16][17][18] In the present study, we identified >500 congenital heart defect cases among both twins and singletons, which allowed for subanalyses of specific congenital heart defects restricted to, for example, operated congenital heart defect cases. Information from the Danish Twin Registry [19][20][21] provided information about zygosity of the twins, thereby also enabling us to make inferences about the impact of chorionicity.…”

Section: Editorial See P 1173 Clinical Perspective On P 1188mentioning

confidence: 99%

Increased Prevalence of Congenital Heart Defects in Monozygotic and Dizygotic Twins

2013

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Background-Smaller studies and many case series reports indicate that congenital heart defects may be more common in monochorionic twins than in dichorionic twins and singletons. Methods and Results-We investigated congenital heart defect occurrence in all twins and 5% of all singletons born in Denmark in 1977-2001 and followed through 2006 by linking the Danish Twin Registry and Statistics Denmark registers including the National Medical Birth Register and the Danish National Patient Register. Among 41 525 twin individuals, a total of 584 twins (1.4%) had a congenital heart defect registered in the Danish National Patient Register, whereas the corresponding numbers for singletons were 648 of 74 473 (0.87%; P<0.001; ie, a 63% [95% confidence interval, 45-82%] increased risk for congenital heart defect for twins). Patent ductus arteriosus and coarctation of aorta occurred >3 times as often in twins as in singletons, at 3.9 (95% confidence interval, 2.6-5.8) and 3.1 (95% confidence interval, 1.5-6.4), respectively. The increased occurrence in twins was also found in sensitivity analyses including only inpatients or only surgically treated cases regardless of whether preterm patent ductus arteriosus was included. We were not able to demonstrate a higher risk for congenital heart defect among monozygotic twins compared with dizygotic twins, and the congenital heart defect occurrence was also increased in dizygotic twins, who are all dichorionic. Conclusions-Congenital heart defect is more common in twins than in singletons, and the increased occurrence is not restricted to monochorionic twins. Intrauterine surveillance and a postnatal comprehensive cardiac assessment for both twins may be considered regardless of chorionicity and zygosity. (Circulation. 2013;128:1182-1188.)

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Congenital Heart Defects and Developmental and Other Psychiatric Disorders

Cited by 46 publications

References 44 publications

Risk of Dementia in Adults With Congenital Heart Disease

Risk of Dementia in Adults With Congenital Heart Disease

Congenital Heart Defects and Indices of Fetal Cerebral Growth in a Nationwide Cohort of 924 422 Liveborn Infants

Increased Prevalence of Congenital Heart Defects in Monozygotic and Dizygotic Twins

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