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. 2025 Jul 24:287:114752.
doi: 10.1016/j.jpeds.2025.114752. Online ahead of print.

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

Tyler Kuni  1 , Alana Cianciulli  1 , Richard F Ittenbach  2 , Gabrielle Combs  1 , Isabel Randazzo  1 , Daniel J Licht  3 , Lyla Hampton  4 , Marsha Gerdes  5 , Judy Bernbaum  6 , J William Gaynor  1 , Nancy Burnham  7
Affiliations

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

Tyler Kuni et al. J Pediatr. .

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.

Keywords: CHD Preschool; CHD Young Adults; Health Related Quality of Life; RS-14; SF-36; chd; neurobehavioral development; neurodevelopment; psychosocial development; resilience.

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Conflict of interest statement

Declaration of Competing Interest This project was funded by the National Institutes of Health grant “APOE Genotype and Sequelae of Infant Cardiac Surgery” [HL64388-02], the Thomas L. Spray, MD, Endowed Chair in Pediatric Cardiothoracic Surgery and the Daniel M. Tabas Endowed Chair in Pediatric Cardiothoracic Surgery at the Children's Hospital of Philadelphia.

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