Resilience in Young Adults with Congenital Heart Disease in Relation to Neurodevelopment in the Preschool Period

Abstract

Objective

To determine if resilience among young adults with congenital heart disease is associated with patient characteristics and neurobehavioral status during the preschool period.

Study design

This study is a prospective, cross-sectional analysis of young adults enrolled in a longitudinal study of neurodevelopmental outcomes in congenital heart disease. All subjects underwent surgery with cardiopulmonary bypass at age ≤6 months of life. Resilience and general health status were evaluated using standardized questionnaires (RS-14 and SF-36, respectively). The relationships between resilience and patient and management factors as well as neurobehavioral status in the preschool period were examined.

Results

The RS-14 and SF-36 were completed by 200 subjects (average age 20.1, IQR 19.2, 21.3 years). Median resilience score was 81.0 (CL0.95 78, 82), higher than the population average of 76.0 (P = .014). Higher resilience scores were correlated with higher health-related quality of life scores (r = 0.506, P < .001). Better executive function (P = .032) and social skills (P = .004) at the 4-year evaluation were associated with higher resilience in young adulthood. Inattention (P = .015) and pervasive development problems (P = .020) were inversely associated with resilience. No demographic, patient-related, or operative management factors were associated with higher or lower resilience (all P > .223).

Conclusions

Findings reported here show an association between preschool neurobehavioral status, overall health-related quality of life, and resilience in young adulthood. Identification of an at-risk population may provide an opportunity for intervention early in life, leading to improved psychosocial development with increased resilience.