Microcephaly is associated with impaired educational development in children with congenital heart disease

Constanze Pfitzer; Laura K Sievers; Alina Hütter; Hashim-Abdul Khaliq; Martin Poryo; Felix Berger; Ulrike M M Bauer; Paul C Helm; Katharina R L Schmitt

doi:10.3389/fcvm.2022.917507

Microcephaly is associated with impaired educational development in children with congenital heart disease

Front Cardiovasc Med. 2022 Oct 6:9:917507. doi: 10.3389/fcvm.2022.917507. eCollection 2022.

Authors

Constanze Pfitzer^{1

2

3}, Laura K Sievers⁴, Alina Hütter¹, Hashim-Abdul Khaliq⁵, Martin Poryo⁵, Felix Berger^{1

3

6}, Ulrike M M Bauer^{7

8}, Paul C Helm^{7

8}, Katharina R L Schmitt^{1

3}

Affiliations

¹ Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
² Berlin Institute of Health (BIH), Berlin, Germany.
³ DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.
⁴ Department of Internal Medicine I., Christian-Albrechts-University and University Hospital Schleswig-Holstein, Kiel, Germany.
⁵ Department of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany.
⁶ Department of Pediatric Cardiology, Charite - Universitaetsmedizin Berlin, Berlin, Germany.
⁷ National Register for Congenital Heart Defects, Berlin, Germany.
⁸ Competence Network for Congenital Heart Defects, Berlin, Germany.

Abstract

Objectives: This study aims to evaluate the school careers of patients with congenital heart disease (CHD) and microcephaly.

Methods: An exploratory online survey was conducted on patients from a previous study on somatic development in children with CHD in 2018 (n = 2818). A total of 750 patients participated in the online survey (26.6%). This publication focuses on 91 patients (12.1%) diagnosed with CHD and microcephaly who participated in the new online survey.

Results: Microcephaly was significantly associated with CHD severity (p < 0.001). Microcephalic patients suffered from psychiatric comorbidity two times as often (67.0%) as non-microcephalic patients (29.8%). In particular, the percentage of patients with developmental delay, intellectual debility, social disability, learning disorder, or language disorder was significantly increased in microcephalic CHD patients (p < 0.001). A total of 85.7% of microcephalic patients and 47.6% of non-microcephalic patients received early interventions to foster their development. The school enrollment of both groups was similar at approximately six years of age. However, 89.9% of non-microcephalic but only 51.6% of microcephalic patients were enrolled in a regular elementary school. Regarding secondary school, only half as many microcephalic patients (14.3%) went to grammar school, while the proportion of pupils at special schools was eight times higher. Supportive interventions, e.g., for specific learning disabilities, were used by 52.7% of microcephalic patients and 21.6% of non-microcephalic patients.

Conclusion: Patients with CHD and microcephaly are at high risk for impaired educational development. Early identification should alert clinicians to provide targeted interventions to optimize the developmental potential.

Keywords: congenital heart disease; development; education; microcephaly; school; supportive interventions.