To identify subgroups with a congenital heart defect (CHD) at risk of health-related quality of life (QoL) impairment at 8 years of age according to their medical and surgical management.

From a prospective population-based cohort study, 598 patients with CHD were subdivided according to their medical and surgical management: (1) CHD followed-up in an outpatient clinic, (2) complete repair before age 3 years, (3) complete repair after age 3 years, (4) palliative repair, or (5) CHD with spontaneous resolution (reference subgroup). Self-reported QoL and parent-reported QoL were measured using the Pediatric Quality of Life Inventory version 4.0 (score range, 0-100) at age 8 years. Multivariable regression analysis and Cohen effect size were used to compare outcomes across the CHD groups.

Self-reported and parent-reported QoL scores for the palliative repair subgroup were lower (β = −2.1 [95% CI, −3.9 to −0.2] and β = −16.0 [95% CI, −22.4 to −9.5], respectively), with a large effect size (δ = −0.9 [95% CI, −1.4 to −0.4] and δ = −1.3 [95% CI, −1.8 to −0.7], respectively). Parent-reported QoL scores for the complete repair after age 3 years subgroup were lower (β = −9.2; 95% CI, −15.0 to −3.5), with a large effect size (δ = −0.9; 95% CI, −1.4 to −0.5). Self-reported QoL scores for the complete repair before age 3 years subgroup was lower (β = −1.3; 95% CI, −1.9 to −0.6), with a small effect size (δ = −0.4; 95% CI, −0.6 to −0.2).

The QoL of children with CHD who experienced a hospital intervention is reduced at age 8 years. Patient age at the last cardiac intervention might influence QoL at 8 years.