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Early identification of autism spectrum disorder in children with CHD attending a Cardiac Developmental Outcomes Program

Published online by Cambridge University Press:  19 July 2023

Faridis Serrano Open the ORCID record for Faridis Serrano [Opens in a new window] ,
Danielle Guffey ,
Lara Shekerdemian ,
Lisa Noll ,
Robert G. Voigt  and
Sonia Monteiro
Faridis Serrano*
Affiliation:
Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA
Danielle Guffey
Affiliation:
Baylor College of Medicine, Dan L. Duncan Institute for Clinical and Translational Research, Houston, TX, USA
Lara Shekerdemian
Affiliation:
Department of Pediatrics, Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA
Lisa Noll
Affiliation:
Department of Pediatrics, Division of Psychology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA
Robert G. Voigt
Affiliation:
Department of Pediatrics, Division of Developmental Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA
Sonia Monteiro
Affiliation:
Department of Pediatrics, Division of Developmental Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA
*
Corresponding author: F. Serrano; Email: fxserra2@texaschildrens.org
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Abstract

Objective:

To determine the prevalence and timing of autism spectrum disorder diagnosis in a cohort of congenital heart disease (CHD) patients receiving neurodevelopmental follow-up and identify associated risk factors.

Method:

Retrospective single-centre observational study of 361 children undergoing surgery for CHD during the first 6 months of life. Data abstracted included age at autism spectrum disorder diagnosis, child and maternal demographics, and medical history.

Results:

Autism spectrum disorder was present in 9.1% of children with CHD, with a median age at diagnosis of 34 months and 87.9% male. Prematurity, history of post-operative extracorporeal membrane oxygenation, and seizures were higher among those with autism (p = 0.013, p = 0.023, p = 0.001, respectively). Infants with autism spectrum disorder were older at the time of surgery (54 days vs 13.5 days, p = 0.002), and infants with surgery at ≥ 30 days of age had an increased risk of autism spectrum disorder (OR 2.31; 95% CI =1.12, 4.77, p = 0.023). On multivariate logistic regression analysis, being male (OR 4.85, p = 0.005), surgery ≥ 30 days (OR 2.46, p = 0.025), extracorporeal membrane oxygenation (OR 4.91, p = 0.024), and seizures (OR 4.32, p = 0.003) remained associated with increased odds for autism spectrum disorder. Maternal age, race, ethnicity, and surgical complexity were not associated.

Conclusions:

Children with CHD in our cohort had more than three times the risk of autism spectrum disorder and were diagnosed at a much earlier age compared to the general population. Several factors (male, surgery at ≥ 30 days, post-operative extracorporeal membrane oxygenation, and seizures) were associated with increased odds of autism. These findings support the importance of offering neurodevelopmental follow-up after cardiac surgery in infancy.

Keywords

CHDheart surgeryautism spectrum disorderneurodevelopmental outcomeneurodevelopmental disability
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 3 , March 2024 , pp. 483 - 488
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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