Prevalence and Treatment of US Children with Congenital Heart Disease and ADHD: A National Survey Analysis.

Objective

To evaluate the intersection of congenital heart disease CHD and attention-deficit/hyperactivity disorder (ADHD,) in children we analyzed population-level data from the National Survey of Children's Health (NSCH).

Study design

We pooled 2020-2023 NSCH data for children aged 3-17 years old (N = 169,584) with and without parent-reported CHD and compared ADHD prevalence between these groups. Multivariable regression models assessed social and demographic risk factors for ADHD in children with and without CHD.

Results

After multivariable correction, children with CHD had significantly higher prevalence of parent-reported ADHD than those without CHD (18.4% vs 10.7%, P < 0.05), with age-specific prevalence of 1.8% (ages 3-5), 13.1% (ages 6-8), 26.8% (ages 9-11), 25.5% (ages 12-14), and 25.0% (ages 15-17), with no significant differences across survey years. In weighted multivariable logistic regression, older age, male sex, prematurity, poorer parent-reported child health status, and foregone healthcare were associated with higher odds of ADHD in children with and without CHD (P < 0.05). Children with current CHD received treatment for ADHD with medication (44.5%) and behavioral intervention (46.2%) at similar prevalence to children without CHD (50.7% and 42.2%, respectively).

Conclusions

Children with CHD had higher parent-reported ADHD prevalence than peers without CHD, including nearly one in three adolescents aged 12-14. Children with CHD received ADHD treatments at prevalence comparable with those without CHD. Although limited by parent report and survey specificity, these national estimates highlight elevated ADHD prevalence in children with CHD and support strengthened neurodevelopmental surveillance guidelines.