Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-10T05:21:32.272Z Has data issue: false hasContentIssue false
  • English
  • Français

Educational achievement among long-term survivors of congenital heart defects: a Danish population-based follow-up study

Published online by Cambridge University Press:  22 December 2010

Morten Olsen ,
Vibeke E. Hjortdal ,
Laust H. Mortensen ,
Thomas D. Christensen ,
Henrik T. Sørensen  and
Lars Pedersen
Morten Olsen*
Affiliation:
Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark Department of Cardiothoracic and Vascular Surgery, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
Vibeke E. Hjortdal
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
Laust H. Mortensen
Affiliation:
Epidemiology Unit, Institute of Public Health, University of Southern Denmark, Odense, Denmark
Thomas D. Christensen
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
Henrik T. Sørensen
Affiliation:
Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
Lars Pedersen
Affiliation:
Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
*
Correspondence to: Dr M. Olsen, MD, Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Olof Palmes Alle 43–45, DK-8200 Aarhus N, Denmark. Tel: +45 8942 4800; Fax +45 8942 4801; E-mail: mo@dce.au.dk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Congenital heart defect patients may experience neurodevelopmental impairment. We investigated their educational attainments from basic schooling to higher education.

Patients and methods

Using administrative databases, we identified all Danish patients with a cardiac defect diagnosis born from 1 January, 1977 to 1 January, 1991 and alive at age 13 years. As a comparison cohort, we randomly sampled 10 persons per patient. We obtained information on educational attainment from Denmark's Database for Labour Market Research. The study population was followed until achievement of educational levels, death, emigration, or 1 January, 2006. We estimated the hazard ratio of attaining given educational levels, conditional on completing preceding levels, using discrete-time Cox regression and adjusting for socio-economic factors. Analyses were repeated for a sub-cohort of patients and controls born at term and without extracardiac defects or chromosomal anomalies.

Results

We identified 2986 patients. Their probability of completing compulsory basic schooling was approximately 10% lower than that of control individuals (adjusted hazard ratio = 0.79, ranged from 0.75 to 0.82 0.79; 95% confidence interval: 0.75–0.82). Their subsequent probability of completing secondary school was lower than that of the controls, both for all patients (adjusted hazard ratio = 0.74; 95% confidence interval: 0.69–0.80) and for the sub-cohort (adjusted hazard ratio = 0.80; 95% confidence interval: 0.73–0.86). The probability of attaining a higher degree, conditional on completion of youth education, was affected both for all patients (adjusted hazard ratio = 0.88; 95% confidence interval: 0.76–1.01) and for the sub-cohort (adjusted hazard ratio = 0.92; 95% confidence interval: 0.79–1.07).

Conclusion

The probability of educational attainment was reduced among long-term congenital heart defect survivors.

Keywords

Congenital heart defectseducational statuspopulation basedprognosis
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 2 , April 2011 , pp. 197 - 203
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Øyen, N, Poulsen, G, Boyd, HA, Wohlfahrt, J, Jensen, PKA, Melbye, M. National time trends in congenital heart defects, Denmark, 1977–2005. Am Heart J 2009; 157: 467–473.CrossRefGoogle ScholarPubMed
2. Hoffman, JIE, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
3. Nieminen, HP, Jokinen, EV, Sairanen, HI. Causes of late deaths after pediatric cardiac surgery: a population-based study. J Am Coll Cardiol 2007; 50: 1263–1271.CrossRefGoogle ScholarPubMed
4. Marelli, AJ, Mackie, AS, Ionescu-Ittu, R, Rahme, E, Pilote, L. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 2007; 115: 163–172.CrossRefGoogle ScholarPubMed
5. Bruto, VC, Harrison, DA, Fedak, PW, Rockert, W, Siu, SC. Determinants of health-related quality of life in adults with congenital heart disease. Congenit Heart Dis 2007; 2: 301–313.CrossRefGoogle ScholarPubMed
6. Brandhagen, DJ, Feldt, RH, Williams, DE. Long-term psychologic implications of congenital heart disease: a 25-year follow-up. Mayo Clin Proc 1991; 66: 474–479.CrossRefGoogle ScholarPubMed
7. Kovacs, AH, Sears, SF, Saidi, AS. Biopsychosocial experiences of adults with congenital heart disease: Review of the literature. Am Heart J 2005; 150: 193–201.CrossRefGoogle ScholarPubMed
8. Miatton, M, De Wolf, D, Frantois, K, Thiery, E, Vingerhoets, G. Neuropsychological performance in school-aged children with surgically corrected congenital heart disease. J Pediatr 2007; 151: 73–78.CrossRefGoogle ScholarPubMed
9. Shillingford, AJ, Glanzman, MM, Ittenbach, RF, Clancy, RR, Gaynor, JW, Wernovsky, G. Inattention, hyperactivity, and school performance in a population of school-age children with complex congenital heart disease. Pediatrics 2008; 121: 759–767.CrossRefGoogle Scholar
10. Altman, DG. Systematic reviews in health care: systematic reviews of evaluations of prognostic variables. BMJ 2001; 323: 224–228.CrossRefGoogle Scholar
11. Nieminen, H, Sairanen, H, Tikanoja, T, et al. Long-term results of pediatric cardiac surgery in Finland: education, employment, marital status, and parenthood. Pediatrics 2003; 112: 1345–1350.CrossRefGoogle ScholarPubMed
12. van Rijen, EH, Utens, EM, Roos-Hesselink, JW, et al. Psychosocial functioning of the adult with congenital heart disease: a 20–33 years follow-up. Eur Heart J 2003; 24: 673–683.CrossRefGoogle ScholarPubMed
13. Ternestedt, M, Wall, K, Oddsson, H, Riesenfeld, T, Groth, I, Schollin, J. Quality of life 20 and 30 years after surgery in patients operated on for tetralogy of fallot and for atrial septal defect. Pediatr Cardiol 2001; 22: 128–132.CrossRefGoogle ScholarPubMed
14. Otterstad, JE, Tjore, I, Sundby, P. Social function of adults with isolated ventricular septal defects. Possible negative effects of surgical repair? Scand J Soc Med 1986; 14: 15–23.CrossRefGoogle ScholarPubMed
15. Wright, M, Nolan, T. Impact of cyanotic heart disease on school performance. Arch Dis Child 1994; 71: 64–70.CrossRefGoogle ScholarPubMed
16. Nuutinen, M, Koivu, M, Rantakallio, P. Long-term outcome for children with congenital heart defects. A study from 1 year birth cohort born in 1966 in northern Finland. Arctic Med Res 1989; 48: 175–184.Google ScholarPubMed
17. Pedersen, CB, Gøtzsche, H, Møller, JO, Mortensen, PB. The Danish Civil Registration System. A cohort of eight million persons. Dan Med Bull 2006; 53: 441–449.Google ScholarPubMed
18. Health care in Denmark. http://www.sum.dk/publikationer/healthcare_in_dk_2008/index.htmGoogle Scholar
19. ISCED 1997. http://www.unesco.org/education/information/nfsnesco/doc/isced_1997.htmGoogle Scholar
20. European Surveillance of Congenital Anomalies. Guide 1.3 – Instructions for the Registration and Surveillance of Congenital Anomalies. 2009. http://www.eurocat-network.eu/content/EUROCAT-Guide-1.3.pdfGoogle Scholar
21. Koch, SV, Kejs, AM, Engholm, G, Johansen, C, Schmiegelow, K. Educational attainment among survivors of childhood cancer: a population-based cohort study in Denmark. Br J Cancer 2004; 91: 923–928.CrossRefGoogle ScholarPubMed
22. Jepsen, B, Jepsen, P, Johnsen, SP, Espersen, GT, Sørensen, HT. Validity of diagnoses of cardiac malformations in a Danish population-based hospital-discharge registry. Int J Risk Safety Med 2006; 18: 77–81.Google Scholar
23. Moster, D, Lie, RT, Markestad, T. Long-term medical and social consequences of preterm birth. N Engl J Med 2008; 359: 262–273.CrossRefGoogle ScholarPubMed
24. Grech, V, Gatt, M. Syndromes and malformations associated with congenital heart disease in a population-based study. Int J Cardiol 1999; 68: 151–156.CrossRefGoogle ScholarPubMed
25. Tanner, K, Sabrine, N, Wren, C. Cardiovascular malformations among preterm infants. Pediatrics 2005; 116: 833–838.CrossRefGoogle ScholarPubMed
26. Miller, SP, McQuillen, PS, Hamrick, S, et al. Abnormal brain development in newborns with congenital heart disease. N Engl J Med 2007; 357: 1928–1938.CrossRefGoogle ScholarPubMed
27. Kaltman, JR, Di, H, Tian, Z, Rychik, J. Impact of congenital heart disease on cerebrovascular blood flow dynamics in the fetus. Ultrasound Obstet Gynecol 2005; 25: 32–36.CrossRefGoogle ScholarPubMed
28. Hsia, TY, Gruber, PJ. Factors influencing neurologic outcome after neonatal cardiopulmonary bypass: what we can and cannot control. Ann Thorac Surg 2006; 81: 2381–2388.CrossRefGoogle ScholarPubMed
29. Newburger, JW, Wypij, D, Bellinger, DC, et al. Length of stay after infant heart surgery is related to cognitive outcome at age 8 years. J Pediatr 2003; 143: 67–73.CrossRefGoogle ScholarPubMed