Abstract 15999: Beyond Morbidity and Mortality: Academic Outcomes in Children With Congenital Heart Disease

Abstract

Introduction: While children with congenital heart disease (CHD) are known to have neurodevelopmental challenges, how these challenges translate to school performance is unknown. The purpose of our study was to compare the academic achievement of children with CHD to that of children without known birth defects. Hypothesis: Children with CHD would have lower standardized test performance scores and greater need for grade retention than their peers without birth defects. Methods: We performed a retrospective cohort study comparing educational outcomes for children born 1998-2003 with CHD, identified from the North Carolina (NC) Birth Defects Registry, vs. those without a known birth defect, randomly sampled from NC birth certificates. All children were linked to 3rd grade public school records from the NC Department of Public Instruction through 2012. We performed logistic regression to compare our outcomes of interest: a) meeting standards on the reading and math portions of 3rd grade End of Grade Testing, and b) 3rd grade retention. Models were adjusted for maternal education, public pre-K enrollment, and race/ethnicity. Results: Of the 5624 subjects with CHD and 10,832 with no birth defect, 51% and 60% were linked, respectively, to 3rd grade standard End of Grade testing records. Compared to children without a birth defect, those with CHD were more likely not to meet proficiency standards in reading (OR 1.4, 95% CI 1.3-1.6), math (OR 1.2, 95% CI 1.1-1.4), or both (OR 1.5, 95% CI 1.3-1.7). (Figure) Similarly, children with CHD were more likely to be retained in 3rd grade (2.8% vs. 1.9%, OR 1.4, 95% CI 1.1-1.9). Conclusions: Children with CHD have poorer educational achievement as compared to their peers without birth defects. History of CHD should be considered an important factor in determining a student’s need for specialized education services.