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Additional Resources
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What are Congenital Heart Defects?
 Congenital heart defects (CHD) are anatomic abnormalities present at birth that result in abnormal cardiac function. Most are not identified before the child is born. CHDs are the second leading cause of death in infants in their first year (Wong et al., 2003). Congenital heart defects occur in 5-8 out of every 1000 births (Wong et al., 2003). Only 50% of CHDs are apparent in the first year of life and 30% are identifiable at the time of birth (Wong et al.). Furthermore, there are 35 different CHDs that vary in incidence and severity. Congenital heart defects cause either congestive heart failure or hypoxemia in children. Generally, the defects that result in hypoxemia cause the characteristic blue color of infants with a heart problem while congestive heart failure manifests slower and all CHDs require immediate care and correction if they are severe.
What Causes Congenital Heart Defects?
CHDs are caused by a complex interaction of genetic and environmental factors and the etiology is 90% unknown. Maternal factors that are known to increase the chances of a newborn having a CHD are: maternal chronic illness, alcohol consumption, and environmental toxins and infections. Congenital heart defects also have a genetic component to them; this greatly increases the chances for a newborn to have a CHD if a parent or sibling has one. Twenty-eight percent of CHDs occur with chromosomal abnormalities, syndromes, and other congenital defects (Wong et al., 2003).
How do Congenital Heart Defects Affect Attachment?
Newborns with a CHD are separated from their families and taken to the neonatal intensive care unit (NICU) in order to receive the care they need. This disrupts the natural process of attachment of families and their infants and replaces it with separation and stress. When separated from their newborns families must adjust and adapt to these changes. If this process does not occur effectively families are at increased risk for stress and an inability to adapt to these changes that can cause attachment problems, which have long-term implications for both child and family (Wong et al., 2003).
Morelius, Lundh, & Nelson (2002) found children with a CHD have insecure relationships with their mothers. When a severe CHD is present and separation occurs attachment issues are increased. These attachment issues must be addressed in order to secure parent-child relationships. Parents must cope with the diagnosis, NICU, separation, and adjustment while trying to form a bond with their child.
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[Background]
[Stressors]
[Coping]
[Attachment]
[Family as Client]
[Main]
References
Morelius, E., Lundh, U., & Nelson, N. (2002). Parental stress in relation to the severity of congenital heart disease in the offspring. Pediatric Nursing, 28(1), 28-34.
Wong, D.L., Hockenberry, M.J., Wilson, D., Winklestein, M.L.& Kline, N.E. (2003). Wong�s nursing care of infants and children. (7th ed.). Toronto: Mosby.
This site was built by Haylie A. Isaac, Kwantlen University College, Student Nurse, April 2003
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