WIP 45 - Prevalence of Adverse Childhood Experiences (ACEs) in the Congenital Heart Disease Population in Los Angeles County

Publication Number: WIP 45.7575

Karina Mehta, Children's Hospital Los Angeles, Los Angeles, CA, United States; Celia Draycott, ACEs-LA, Los Angeles County Health Services, Brooklyn, NY, United States; Nina N. Thompson, Olive View-UCLA Education and Research Institute, San Francisco, CA, United States; Jon Detterich, Children's Hospital Los Angeles, Los Angeles, CA, United States; Shannon M.. Thyne, David Geffen School of Medicine at UCLA, Sylmar, CA, United States

Background: Adverse Childhood Experiences (ACEs) were first described in 1998 and refer to the strong relationship between the number of adverse events experienced in childhood and poor health outcomes in adults. Increased ACE scores correlate with negative health outcomes in adulthood, including cardiovascular disease. Congenital heart disease (CHD) accounts for nearly 1% of live births, and mortality rates for children with CHD have decreased significantly. However, adults with CHD are at an increased risk of developing acquired cardiovascular disease, indicating the importance of understanding the prevalence of high ACE scores in the CHD population.

Objective: ACEs are a testament to the complicated nature of how environment, biology, and toxic stress can contribute to negative health outcomes in adulthood. CHD patients are a unique population in that they have experienced early, repeated, and prolonged exposure to the healthcare system. The research on ACEs and their health impacts is relatively new, indicating the need for further research to help identify and address preventive and protective factors that can be used to mitigate the effects of adverse experiences in childhood. Our objective is to determine the prevalence of ACEs in the CHD population within a large safety net health care system in Los Angeles County.

Design/Methods: This study is a retrospective chart analysis of pediatric patients (age 0-20) in Los Angeles County who have completed at least one ACE screen between 2019 and 2024, who also carry an ICD-10 diagnosis code associated with congenital heart disease. We have identified about 500 children who meet this inclusion criteria. The IRB was submitted and accepted through LA County Department of Health Services. Data collection is anticipated to be completed by December 2024 and data analysis will be completed by February 2025. Investigators will undertake basic statistical analysis to assess general prevalence of ACEs among patients with CHD. This will be compared to existing prevalence data for the general pediatric population that has been screened for ACEs.