Effet additif de la cardiopathie congénitale et des troubles précoces du développement sur le trouble de déficit d'attention / hyperactivité et le trouble du spectre de l'autisme: une étude longitudinale de population à l'échelle nationale

Aperçu: G.M.

Les chercheurs ont étudié l'impact de la maladie cardiaque congénitale (CHD) sur le développement du trouble déficitaire de l'attention / hyperactivité (TDAH) et du trouble du spectre de l'autisme (TSA), qui reste incertain.

Les résultats ont suggéré que la CHD à la naissance et les troubles développementaux précoces (EDD) au début de l'enfance étaient deux facteurs de risque indépendants pour le TDAH et les TSA et que les maladies coronariennes et les EDD simultanées pourraient également augmenter ces risques.

Eur Child Adolesc Psychiatry. 2017 Apr 17. doi: 10.1007/s00787-017-0989-8.

Additive effect of congenital heart disease and early developmental disorders on attention-deficit/hyperactivity disorder and autism spectrum disorder: a nationwide population-based longitudinal study

Tsao PC^1,2,3,4, Lee YS^2,3,5, Jeng MJ^2,3,4, Hsu JW^6,7, Huang KL^6,7, Tsai SJ^6,7, Chen MH^6,7, Soong WJ^2,3, Kou YR^8,9.

Author information

1

Institute of Physiology, School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, 11221, Taipei, Taiwan.

2

Division of General Pediatrics, Pediatrics Department, Taipei Veterans General Hospital, Taipei, Taiwan.

3

Department of Pediatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

4

Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

5

Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.

6

Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.

7

Department of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Taipei, Taiwan.

8

Institute of Physiology, School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, 11221, Taipei, Taiwan. yrkou@ym.edu.tw.

9

Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. yrkou@ym.edu.tw

Abstract

In this retrospective nationwide population-based case-control study, we investigated the impact of congenital heart disease (CHD) on the development of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), which remains unclear. Children aged <18 years that were diagnosed with CHD (n = 3552) between January 1, 1997 and December 31, 2009 were identified from the National Health Insurance Research Database in Taiwan. Non-CHD controls (n = 14,208) matched for age and sex (1:4) were selected from the same dataset. All subjects were observed until December 31, 2011 or their death. Comorbid perinatal conditions and early developmental disorders (EDD) that were diagnosed before ADHD and ASD diagnosis were also analyzed. The incidence rates of perinatal comorbidities, EDD, ADHD, and ASD were higher in the CHD group than in the control group. Multivariate Cox regression analysis revealed that the CHD group had an increased risk of developing ADHD (adjusted hazard ratio [aHR] 2.52, 95% confidence interval CI 1.96-3.25) and ASD (aHR 1.97, 95% CI 1.11-3.52) after adjusting for confounding comorbidities. EDD, but not perinatal comorbidities were also independent risk factors for ADHD and ASD after adjustment. Subgroup analysis indicated that the risk for ADHD (HR 16.59, 95% CI 12.17-22.60) and ASD (HR 80.68, 95% CI 39.96-176.12) was greatly increased in CHD subjects with EDD than in non-CHD subjects without EDD. These findings suggested that CHD at birth and EDD during early childhood were two independent risk factors for ADHD and ASD and that concurrent CHD and EDD might additively increase these risks.

PMID: 28417257

DOI: 10.1007/s00787-017-0989-8