Abstract
Ventricular septal defect (VSD) is the most common congenital heart defect, with larger VSDs typically being corrected with an open-heart surgery during infancy. Long-term consequences of a VSD-corrective surgery on stress systems of child and mother are still unknown. The aim of the present study is to investigate the associations of an early corrected VSD and diurnal cortisol release of child and mother. 26 children (12 boys) between 6 and 9 years old, who underwent surgery for an isolated VSD within the first 3 years of life, and their mothers participated in the study. Their diurnal cortisol profiles were compared to a sex-, age-, and socioeconomic status-matched healthy control group. Within the VSD group, associations between cortisol and characteristics of surgery and hospitalization were investigated. Child and mother psychopathological symptoms were considered as a possible interfering mechanism of altered cortisol profiles. Diurnal cortisol profiles of children with an early corrected VSD did not differ from those of controls. However, mothers of affected children exhibited higher cortisol levels in the morning (p < 0.001, [Formula: see text]) and a steeper diurnal cortisol slope (p = 0.016, [Formula: see text]) than mothers of healthy children. Results indicate a favorable development of children with an early corrected VSD, in terms of comparable diurnal cortisol profiles with healthy controls, according to a comparable mother-rated psychopathology. Mothers of affected children reveal altered diurnal cortisol levels, without differences in self-rated psychopathology. This divergence should be clarified in future research.
Highlights
Ventricular septal defect (VSD) is the most common congenital heart defect (CHD), with a worldwide birth prevalence of 2.62 per 1,000 live births [1]
Children were investigated at the age of 6.0–8.8 years (VSD: M = 7.1, SD = 0.9; controls: M = 7.3, SD = 0.6), their mothers were between 24 and 49 years old (VSD: M = 35.2, SD = 4.8; controls: M = 39.7, SD = 4.6)
There were no differences in child [SDQ: VSD: M = 8.7, SD = 5.2; controls: M = 9.3, SD = 6.4] or mother psychopathology [BSI: VSD: M = 44.6, SD = 13.4; controls: M = 46.2, SD = 14.5] or mother-rated everyday stress [ESI: VSD: M = 34.2, SD = 10.5; controls: M = 36.2, SD = 8.4] between the groups
Summary
Ventricular septal defect (VSD) is the most common congenital heart defect (CHD), with a worldwide birth prevalence of 2.62 per 1,000 live births [1]. Studies from other cohorts that require early-life surgery showed that a pediatric surgery, seen as a life-threatening event in the case of complications and the possibility of permanent impairments, can act as a traumatic event This may lead to increased symptoms of anxiety and posttraumatic stress disorder in the children and their mothers [3, 4]. Studies investigating the effects of CHD have mainly combined different defects, with only two studies focusing on VSD These studies found comparable results for children with an early corrected VSD, with parents reporting more internalizing and externalizing problems in their children than those of healthy controls [6, 7]. In the long term, the majority of results indicate a negative impact of CHD on parents in terms of higher stress levels or more symptoms of depression and anxiety than reference groups [10]
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