The Prevalence of Adverse Childhood Experiences in the Congenital Heart Disease Population in Los Angeles County

Adverse Childhood Experiences (ACEs) correlate with increased risk of cardiovascular disease in adulthood and children with congenital heart disease (CHD) are also at increased risk of negative cardiovascular outcomes as adults. This study sought to identify the prevalence of ACEs in the pediatric CHD population in Los Angeles County and to identify any differences in healthcare utilization between pediatric patients with and without CHD. Data on children ages 0–26 with at least one ACE score in the study period were collected. Pediatric patients with CHD were identified from this cohort and propensity matching across gender, race and ethnicity, and age was performed using the patients with CHD as the case population. Statistical analysis was performed to evaluate the prevalence of ACEs in the CHD population and controls and to evaluate healthcare utilization differences. 249 pediatric patients with CHD were identified of the 45,000 patients who receive primary care within a safety net hospital system in LA County. When comparing ACE scores between CHD patients and controls, patients with CHD were less likely to have any exposure to ACEs (p = 0.0093) and less likely to have 1–3 ACEs (p = 0.028) than their matched cohorts. Pediatric patients with CHD had significantly higher rates of healthcare utilization as compared to their propensity-matched peers. The prevalence of ACEs in a large CHD population is lower than a group of propensity-matched patients without CHD, and children with CHD had significantly more interactions with the healthcare system. This may provide some early insight into protective factors against ACEs in a high-risk population of pediatric patients.