{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T21:42:22Z","timestamp":1789508542869,"version":"build-2803163510"},"reference-count":64,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Improved survival in children with congenital heart disease (CHD) has unveiled associated long\u2010term neurodevelopmental impairments. However, the long\u2010term effects on academic performance and the influence of sex, family, socioeconomic factors, and surgical era remain understudied, limited by small and incomplete cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This total\u2010population cohort study with nested sibling analysis included all singletons born in Sweden between 1987 and 2005 who had complete socioeconomic data and resided in Sweden at age 16 years. Academic achievement at age 16 was assessed by upper secondary school qualification. Poisson and logistic regression were used to estimate adjusted prevalences, risk ratios, and risk differences. Adjustments were made for year of birth and socioeconomic status. Stratification by noncardiac congenital anomalies, sex, and surgical era was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Of 1\u2009800\u2009477 singletons included, 16\u2009075 (0.9%) had CHD, classified hierarchically as univentricular heart (n=349), severe (n=1939), moderate (n=1764), or mild CHD (n=12\u2009023). After excluding major noncardiac congenital anomalies, the adjusted risk difference for failing to meet upper secondary school qualification compared with children without CHD was 11 (95% CI, 5\u201317), 7 (95% CI, 4\u20139), 6 (95% CI, 3\u20138), and 2 (95% CI, 2\u20133) additional children per 100 for univentricular heart, severe, moderate, and mild CHD, respectively. Children with both CHD and noncardiac anomalies had poorer academic outcomes than those with CHD alone. Findings were consistent in sibling analyses and over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Adolescents with CHD inherently face poorer academic performance, worsening with disease severity and persisting over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.049927","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:20:38Z","timestamp":1783074038000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Academic Achievements in Adolescents With Congenital Heart Disease: A Total Population\u2010Based Cohort Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1509-5645","authenticated-orcid":false,"given":"Sofia","family":"Ekmark 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