title: Early repair of congenital heart disease associated with increased rate of attention deficit hyperactivity disorder symptoms.
abstract: BACKGROUND
  As more children survive with congenital heart disease, their neurodevelopmental outcomes (including attention deficit hyperactivity disorder [ADHD]) are becoming increasingly important. The objective of our study was to determine if school-aged children who underwent early cardiac surgery for congenital heart disease are more likely than healthy control subjects to have screening scores on the Swanson, Nolan, and Pelham IV (SNAP-IV) questionnaire suggestive of ADHD.
  
  
  METHODS
  Children aged 7-15 years who underwent open-heart surgery before 1 year of age were identified from the Izaak Walton Killam (IWK) Children's Heart Centre Database. Control subjects were recruited from healthy volunteers. The SNAP-IV questionnaire was administered to all participants and a chart review was performed on all eligible children in the cardiac surgery group. Case and control subjects were compared using Fisher's exact test, linear, and logistic regression analyses. Potential predictors of a positive screening score were sought.
  
  
  RESULTS
  A positive screening score was found in 29% (16/56) of the surgical group compared with 3% (2/60) of the control group (P < 0.001). Surgical and control subjects differed in average overall scores (0.93 vs 0.30; P < 0.001) and in scores for hyperactivity (0.83 vs 0.24; P < 0.001) and inattention (1.04 vs 0.37; P < 0.001). No other significant predictors of a positive screening score were identified. The early open-heart surgery participants who responded to the questionnaire did not differ in baseline characteristics compared with nonresponders.
  
  
  CONCLUSIONS
  Children who have open-heart surgery at younger than 1 year of age are more likely than healthy control subjects to have a SNAP-IV score suggestive of ADHD when they reach school age.
authors.affiliation: IWK Health Centre, Halifax, Nova Scotia, Canada.
authors.forename: Drew C
authors.initials: DC
authors.lastname: Yamada
authors.forename: Aisling A
authors.initials: AA
authors.lastname: Porter
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Conway
authors.forename: John C
authors.initials: JC
authors.lastname: LeBlanc
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Shea
authors.forename: Camille L
authors.initials: CL
authors.lastname: Hancock-Friesen
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Warren
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D061345:Early Medical Intervention / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening; D009674:Nova Scotia; D011183:Postoperative Complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires