According to a large study, children born with heart problems are 32% more likely to have autism than their typical peers.1.
Unexpectedly, the milder defects are strongly linked to autism, but the more serious are not, the researchers found.
A growing body of research shows that children whose hearts do not form properly in utero also tend to have problems with brain development. In 2012, the American Heart Association and the American Academy of Pediatrics jointly recommended that physicians monitor brain development in children born with heart defects. A 2017 study in Taiwan found that children born with heart defects are twice as likely to have autism2.
The new study is about twice the size of this one, and it supports the 2012 recommendations.
âI hope the result will be that providers, families and schools recognize that, yes, this is a real problem,â says the lead investigator. Matthew Oster, pediatric cardiologist at Children’s Healthcare in Atlanta, Georgia. The prevalence of autism in children with heart problems is still low, he notes, but “we should just be a little more vigilant in looking for signs and symptoms of autism.”
The Oster team sifted through the US Military Health System Data Repository for records of children born between October 2000 and October 2011 who had been in the system for at least two years. They identified 35,040 children: 8,760 diagnosed with autism and three controls matched by age and sex for each.
The link between heart defects and autism persisted even after researchers took into account factors such as maternal age and genetic conditions associated with autism.
The team then grouped 54 heart defects into eight categories. They speculated that autism would be strongly associated with severe heart defects, which can affect blood flow to the brain during gestation or soon after birth. But their analysis showed no such association and instead found a strong link with relatively mild heart defects, which usually don’t affect blood flow: having a hole in the wall between the heart chambers, for example. The results appeared on October 10 in Pediatrics.
This level of detail is “the big contribution of this study,” says Lisa Croen, director of the autism research program at Kaiser Permanente in Oakland, Calif., Who was not involved in the work.
Findings suggest the link between heart defects and autism may be genetic, says Martina brueckner, a professor of pediatric cardiology and genetics at Yale University, who was not involved in the study. Brueckner’s group discovered an overlap between genes linked to autism and those linked to congenital heart disease.
However, some experts are not ready to dismiss the idea of ââa link between serious heart problems and autism.
For example, unpublished work by Sonia monteiroThe s team shows that children who have had open heart surgery are more likely to be diagnosed with autism.
âI don’t think I’m ready to close the door and say that kids with more severe congenital heart disease don’t have a higher risk,â says Monteiro, assistant professor of pediatrics at Baylor College of Medicine in Houston, Texas. . But this article opened my eyes to say, ‘Okay, I think every child with congenital heart disease needs very close monitoring. “”
Oster’s group plans to follow children with congenital heart defects into adulthood to look for any lasting effects on brain function.