133 - Cardiovascular Health Among Youth with Neurodevelopmental Disability: Analysis of National Survey of Children's Health (NSCH)-2021

Publication Number: 133.4093

Carissa M. Baker-Smith, Nemours Children's Hospital, Ellicott City, MD, United States; ZUGUI ZHANG, Christiana Care Health System, Newark, DE, United States; Shannon Robson, University of Delaware, Newark, DE, United States; Freda Patterson, University of Delaware, Newark, DE, United States; Benjamin Brewer, Virginia Tech Carilion School of Medicine, Charlottesville, VA, United States; Jung-Mei Tsai, University of Delaware, Newark, DE, United States; Anjana Bhat, University of Delaware, Garnet Valley, PA, United States

Background: The National Survey of Children's Health (NSCH) provides data for key measures of child health and well-being. The aim of this study is to characterize the cardiovascular health (CVH) status of youth with neurodevelopmental disabilities (NDD) compared to those without neurodevelopmental disabilities (non-NDD).

Objective: Youth with NDD are more likely to have poor CVH status compared to non-NDD youth.

Design/Methods: We compared the odds of poor CVH status in youth with NDD vs non-NDD, using 2021 NSCH data, according to a modified American Heart Association (AHA) Life’s Essential 8 (LE8) scoring system. Participants were identified as having NDD based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and a diagnosis of an intellectual, communication, autism spectrum, attention-deficit/hyperactivity, specific learning, or neurodevelopmental motor disorder, including Tic disorder. The CVH status of each youth was scored according to a modified AHA LE8 score- range 0 to 100 points, with higher scores indicating good CVH. Individual scores were generated for sleep (sleep duration), smoking (smoking/exposure), diabetes mellitus (yes/no), obesity (BMI percentile), heart condition (yes/no), and dyslipidemia (yes/no). A composite CVH score was generated using scores for sleep, smoking, diabetes mellitus, and obesity. Logistic regression was used to analyze the relationship between NDD (vs non-NDD) and CVH status. Propensity score techniques were applied to address the potential selection bias between NDD and non-NDD.

Results: 12,134 youth, 3 to 17 years of age, were identified as having NDD and 44,960 without. Compared to those with NDD, non-NDD participants were less likely to have age-inappropriate sleep duration (63.4 vs. 55.3, p < 0.0001), smoking/exposure (94.5 vs. 90.7, p< 0.0001), diabetes mellitus (95.2 vs. 90.2, p < 0.0001), obesity (80.0 vs. 73.2, p < 0.0001), a heart condition (95.4 vs. 93.8, p=0.021), or dyslipidemia (98.1 vs. 95, p< 0.0001). Overall CVH status was (93.9 vs. 91.0, p< 0.0001) among non-NDD vs NDD participants. NDD participants had a greater odd of having a heart condition (OR=1.91, 95% CI: 1.51-2.42) and poor CVH status (OR=1.53, 95% CI: 1.45-1.62). Propensity score matching showed similar results.

Conclusion(s): Neurodevelopmental disability is associated with poorer CVH status in youth. Efforts to improve CVH status in youth should include greater focus on youth with NDD.