Abstract Body: Background: Adverse childhood experiences (ACEs), social determinants of health, and adverse birth outcomes significantly impact children's well-being. Stress, psychological distress, and adverse birth outcomes contribute to various health issues, including heart-related conditions. This study explores the relationship between these factors and heart health in children to inform interventions and policies.

Methods: Data from the National Survey of Children’s Health (NSCH) from 2016 to 2019 were analyzed. The NSCH provides comprehensive data on children's health. US households were randomly contacted by mail, and one child from each eligible household was selected. The overall weighted response rates ranged from 37.4% to 43.1%, with 131,774 children aged 0 to 17 years included. Key variables included bullying, emotional support from family, peers, and healthcare providers, parental divorce, birth weight, preterm birth, and heart conditions. Logistic regression analysis evaluated the relationship between these factors and heart-related conditions, controlling for confounders.

Results: The prevalence of heart-related conditions was 2.40%. Bullying was reported by 4.15% of children as definitely true, 18.87% as somewhat true, and 76.98% as not true. Emotional support from family was reported by 89.44%, from peers by 12.65%, and from healthcare providers by 28.70%. Parental divorce was experienced by 22.43% of children. Very low birth weight was reported in 1.18%, low birth weight in 6.50%, and preterm birth in 10.83% of the sample. Logistic regression showed bullied children were 1.93 times more likely to have a heart condition. Emotional support from healthcare providers was associated with a 1.34 times higher likelihood of heart conditions. Low birth weight and preterm birth were associated with higher likelihoods of heart conditions (OR: 1.50 and 1.54, respectively). Emotional support from family, peers, and parental divorce were insignificant predictors.

Conclusion: Adverse experiences such as bullying and adverse birth outcomes significantly increase the likelihood of heart-related conditions in children. Emotional support from healthcare providers also plays a crucial role. Interventions targeting bullying, enhancing emotional support, and addressing risks associated with adverse birth outcomes can mitigate long-term health impacts. Early intervention strategies are essential to improve children's health outcomes and prevent long-term cardiovascular issues.