TY - JOUR
T1 - Comparison of Economic Self-Sufficiency and Educational Attainment in Adults With Congenital Heart Disease Versus Siblings Without Heart Disease and to General Population
AU - Madsen, Nicolas L.
AU - Marino, Bradley S.
AU - Woo, Jessica G.
AU - Olsen, Morten
N1 - Funding Information:
Cincinnati Children's Hospital Heart Institute and the Department of Clinical Epidemiology at the University of Aarhus, Denmark.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/11/15
Y1 - 2020/11/15
N2 - Among children with congenital heart disease (CHD), there is often neurodevelopmental and behavioral impairment with unclear implications regarding adult socioeconomic achievements. We aimed to compare economic self-sufficiency and educational attainment in CHD adults with sibling and general population controls. Using Danish population-based nationwide registries, this cohort study aimed to include all CHD subjects greater than 13 years born between 1963 and 1993. Comparison cohorts included: (1) sibling cohort and (2) general population cohort matched 10:1 on birth year and gender. We computed cumulative incidences of time to first full year of economic self-sufficiency, as well as educational attainment. We assessed the relative probability of self-sufficiency in all cohorts before 30 years of age, defined by Statistics Denmark federal standard. In total, we identified 7,019 CHD subjects, 6,257 full siblings, and 68,805 general population controls. The cumulative incidence of self-sufficiency by age 20 and 35 years for CHD subjects (49% and 84%, respectively) was lower than sibling (68% and 96%) and general population cohorts (67% and 95%). The relative probability of self-sufficiency for CHD subjects compared with siblings was 0.44 (95% confidence interval 0.39 to 0.49). By age 30, adults with CHD were less likely than their siblings to attain all levels of education. Among those achieving higher educational milestones, differences in self-sufficiency between cohorts were absent by age 35. In conclusion, CHD is associated with reduced adult economic self-sufficiency, and the relation between educational level attained and self-sufficiency may suggest that targeted interventions have the potential to improve adult self-sufficiency.
AB - Among children with congenital heart disease (CHD), there is often neurodevelopmental and behavioral impairment with unclear implications regarding adult socioeconomic achievements. We aimed to compare economic self-sufficiency and educational attainment in CHD adults with sibling and general population controls. Using Danish population-based nationwide registries, this cohort study aimed to include all CHD subjects greater than 13 years born between 1963 and 1993. Comparison cohorts included: (1) sibling cohort and (2) general population cohort matched 10:1 on birth year and gender. We computed cumulative incidences of time to first full year of economic self-sufficiency, as well as educational attainment. We assessed the relative probability of self-sufficiency in all cohorts before 30 years of age, defined by Statistics Denmark federal standard. In total, we identified 7,019 CHD subjects, 6,257 full siblings, and 68,805 general population controls. The cumulative incidence of self-sufficiency by age 20 and 35 years for CHD subjects (49% and 84%, respectively) was lower than sibling (68% and 96%) and general population cohorts (67% and 95%). The relative probability of self-sufficiency for CHD subjects compared with siblings was 0.44 (95% confidence interval 0.39 to 0.49). By age 30, adults with CHD were less likely than their siblings to attain all levels of education. Among those achieving higher educational milestones, differences in self-sufficiency between cohorts were absent by age 35. In conclusion, CHD is associated with reduced adult economic self-sufficiency, and the relation between educational level attained and self-sufficiency may suggest that targeted interventions have the potential to improve adult self-sufficiency.
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U2 - 10.1016/j.amjcard.2020.08.035
DO - 10.1016/j.amjcard.2020.08.035
M3 - Article
C2 - 32866448
AN - SCOPUS:85091491332
SN - 0002-9149
VL - 135
SP - 135
EP - 142
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -