Congenital heart disease entails increased odds of autism spectrum disorder

Children with congenital heart disease (CHD) are at increased risk of developing autism spectrum disorder (ASD), particularly those with atrial or ventricular septal defect, a recent study suggests.

Researchers conducted a case-control study of 8,760 children with ASD and 26,280 non-ASD controls using data from the US Military Health System. The two groups were similar in terms of characteristics, and 79.9 percent of participants in each group were boys.

Compared with controls, children with ASD had greater susceptibility to genetic syndrome, preterm birth, neonatal epilepsy, birth asphyxia and low birth weight. Furthermore, mothers of children with ASD were more likely to have gestational diabetes and younger age at delivery.

A total of 1,063 children had CHD: 401 in the ASD group and 662 in the control group. In multivariable conditional logistic regression models, any CHD was associated with about 30-percent increased odds of having ASD (odds ratio [OR], 1.33, 95 percent confidence interval [CI], 1.16–1.52).

The elevated ASD risk in CHD patients was largely driven by a significant risk increase observed in subgroups of patients with atrial septal defects (OR, 1.97, 95 percent CI, 1.48–2.61), ventricular septal defects (OR, 1.28, 95 percent CI, 1.00–1.63) and left heart obstructive lesions (OR, 1.42, 95 percent CI, 1.04–1.93).

Sensitivity analysis confirmed the relationship between CHD and increased ASD risk among patients with any CHD (OR, 1.32, 95 percent CI, 1.10–1.59), atrial septal defects (OR, 1.72, 95 percent CI, 1.07–2.74) and ventricular septal defects (OR, 1.65, 95 percent CI, 1.21–2.25).

The present data may be used for counselling parents of children with CHD, the researchers said.