The association of anxiety, depression, developmental disabilities, and congenital heart disease in US children and adolescents.

backgroundCongenital heart disease (CHD) has been linked to the risk of mental health or some developmental disabilities, but there is limited research on the effect of CHD on children and adolescents' mental health and developmental disabilities (varying severity) in the general children and adolescents' population.

methodsThis nationally representative study included 52,846 children and adolescents aged 6-17 years who participated in the 2022-2023 National Survey of Children's Health (NSCH) in the US from July 2022 to January 2024. Weighted adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by multivariable logistic regression models to investigate the association of CHD with anxiety, depression, and multiple developmental disabilities.

resultsFinally, 52,846 children and adolescents representing 38 million US youth aged 6-17 years (mean age 11.47 years, 95% CI: 11.41-11.52) were included. Children and adolescents with CHD was associated with a higher presence of of anxiety (OR, 1.80 [95% CI, 1.37-2.37]), depression (OR, 1.52 [95% CI, 1.02-2.27]), Down syndrome (OR, 25.59 [95% CI, 14.27-61.36]), behavior problems (OR, 2.39 [95% CI, 1.77-3.24]), developmental delay (OR, 3.16 [95% CI, 2.39-4.18]), intellectual disability (OR, 3.81 [95% CI, 2.29-6.33]), speech disorder (OR, 2.61 [95% CI, 1.99-3.43]), learning disability (OR, 2.39 [95% CI, 1.80-3.17]), autism spectrum disorder (ASD) (OR, 2.11 [95% CI, 1.35-3.28]) and attention deficit disorder/attention-deficit hyperactivity disorder (ADD/ADHD) (OR, 2.04 [95% CI, 1.52-2.72]), respectively. In stratified analyses, the ORs for depression, Tourette syndrome, behavior problems, developmental delay, speech disorder, learning disability, ASD, and ADD/ADHD were higher in moderate or severe status than in mild status. The results were similar in the sensitivity analyses.

conclusionIn conclusion, this is the first nationally representative, population-based study to demonstrate that children and adolescents with CHD are associated with increased presence of anxiety, depression, and developmental disabilities in US children and adolescents. The presence of depression and developmental disabilities was higher in moderate or severe status than in mild status. Our findings suggested that early prevention, risk assessment, and support of mental health conditions and developmental disorders in high-risk children and adolescents, such as those with CHD. CLINICAL TRIAL NUMBER: Not applicable.