Taux d'autisme et facteurs de risque potentiels chez les enfants atteints de cardiopathies congénitales

Traduction partielle: G.M.

Congenit Heart Dis. 2017 Mar 16. doi: 10.1111/chd.12461.

Rates of autism and potential risk factors in children with congenital heart defects

Bean Jaworski JL¹, Flynn T¹, Burnham N¹, Chittams JL¹, Sammarco T¹, Gerdes M¹, Bernbaum JC¹, Clancy RR¹, Solot CB¹, Zackai EH¹, McDonald-McGinn DM¹, Gaynor JW¹.

Author information

1

Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvainia, USA.

Abstract

OBJECTIVE:

Le développement atypique, les difficultés comportementales et les lacunes scolaires sont des morbidités courantes chez les enfants ayant des antécédents de cardiopathies congénitales et une qualité de vie de l'impact. Des déficits langagiers et socio-cognitifs ont été décrits, qui sont associés à des troubles du spectre de l'autisme. La présente étude visait à évaluer les taux de troubles du spectre de l'autisme chez un grand échantillon d'enfants ayant des antécédents de cardiopathies congénitales et à évaluer les facteurs médicaux, comportementaux et individuels qui peuvent être associés au risque de troubles du spectre de l'autisme.
Atypical development, behavioral difficulties, and academic underachievement are common morbidities in children with a history of congenital heart defects and impact quality of life. Language and social-cognitive deficits have been described, which are associated with autism spectrum disorders. The current study aimed to assess the rates of autism spectrum disorders in a large sample of children with a history of congenital heart defects and to assess medical, behavioral, and individual factors that may be associated with the risk of autism spectrum disorders.

DESIGN:

Participants included 195 children with a history of congenital heart defects, who are followed in a large-scale longitudinal study. Measures included behavioral data from 4-year-old neurodevelopmental evaluations and parent-report data from a later annual follow-up.

RESULTS:

Using established cutoffs on an autism spectrum disorder screener, children with congenital heart defects showed higher rates of "possible" autism spectrum disorders than national rates, (Chi-square Test of Equal Proportions), all Ps < .05. A stepwise variable selection method was used to create a "best prediction model" and multivariable logistic regression was used to identify variables predicting diagnostic status. Factors associated with diagnostic risk included medical (delayed sternal closure, prematurity, positive genetic findings), behavioral (cognitive, language, attention issues), and individual (socioeconomic, cultural/racial) variables. ROC analyses identified a cutoff of 7 to maximize sensitivity/specificity based on parent-reported diagnosis.

CONCLUSIONS:

Le risque de dépistage du trouble du spectre de l'autisme chez les enfants atteints de cardiopathies congénitales était plus élevé que celui attendu par rapport aux taux de population. Les résultats soulignent la nécessité de renvoyer vers un spécialiste pour évaluer la présence et la gravité des problèmes de communication sociale et les défauts cardiaques congénitaux des seuils de dépistage spécifiques à la population pour les enfants concernés par les troubles du spectre de l'autisme.
Risk of autism spectrum disorder screening status in children with congenital heart defects was higher than expected from population rates. Findings highlight the need for referral to a specialist to assess the presence and severity of social-communication issues and congenital heart defects population-specific screening thresholds for children with concern for autism spectrum disorders.

© 2017 Wiley Periodicals, Inc.

PMID: 28299880

DOI: 10.1111/chd.12461