Richard Feltbower

Background Educational attainment in children with congenital heart disease (CHD) within the UK has not been reported, despite the possibility of school absences and disease-specific factors creating educational barriers. Methods and results Children were prospectively recruited to the Born in Bradford birth cohort between March 2007 and December 2010. Diagnoses of CHD were identified through linkage to the congenital anomaly register and independently verified by clinicians. Multivariable regression accounted for relevant confounders. Our primary outcome was the odds of ‘below expected’ attainment in maths, reading, and writing at ages 4–11 years. Educational records of 139 children with non-genetic CHD were compared with 11 188 age-matched children with no major congenital anomaly. Children with CHD had significantly higher odds of ‘below expected’ attainment in maths at age 4–5 years [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.07–2.52], age 6–7 (OR 2.03, 95% CI 1.32–3.12), and age 10–11 (OR 2.28, 95% CI 1.01–5.14). Odds worsened with age, with similar results for reading and writing. The odds of receiving special educational needs support reduced with age for children with CHD relative to controls [age 4–5: OR 4.84 (2.06–11.40); age 6–7: OR 3.65 (2.41–5.53); age 10–11: OR 2.73 (1.84–4.06)]. Attainment was similar for children with and without exposure to cardio-pulmonary bypass. Lower attainment was strongly associated with the number of pre-school hospital admissions. Conclusion Children with CHD have lower educational attainment compared with their peers. Deficits are evident from school entry and increase throughout primary school.