Quality of life in preschool children with CHD treated in the neonatal period: kiddy-KINDL outcomes and associated factors

Abstract Children with CHD who require surgical or catheter-based intervention in the neonatal period are increasingly surviving into childhood; however, their long-term health-related quality of life remains insufficiently characterised, particularly in the preschool period. We aimed to evaluate health-related quality of life in preschool-aged children treated for CHD during the neonatal period and to identify associated clinical and sociodemographic factors. This retrospective, cross-sectional case–control study included 50 children aged 4–7 years with a history of neonatal CHD intervention and 100 age-matched healthy controls. Health-related quality of life was assessed using the parent-reported Kiddy-KINDL questionnaire. Demographic, clinical, and socio-economic data were obtained from medical records and structured parental interviews. Group comparisons were performed using appropriate parametric or nonparametric tests, and factors associated with health-related quality of life were analysed using multiple linear regression. Total Kiddy-KINDL scores were significantly lower in children with CHD compared with controls (55.4 ± 8.8 vs. 62.3 ± 6.5, p < 0.001). All health-related quality of life subdomains, including physical well-being, emotional well-being, self-esteem, family relations, social functioning, and kindergarten adjustment, were significantly impaired in the CHD group (all p < 0.05). In multivariable analysis, maternal and paternal education levels and household income were independent predictors of health-related quality of life, whereas the surgical risk category was not significantly associated with health-related quality of life outcomes. Preschool children treated for CHD in the neonatal period demonstrate significantly reduced health-related quality of life compared with healthy peers, with socio-economic factors playing a more prominent role than clinical disease severity. These findings underscore the importance of incorporating family-centred and socioeconomically sensitive strategies into the long-term follow-up of children with CHD.