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Growth in children with congenital heart disease

Carrie Daymont1, Ashley Neal, Aaron Prosnitz

  • 1Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada. cdaymont@mich.ca

Pediatrics
|December 12, 2012
PubMed

Insights

Children with congenital heart disease (CHD) show early, significant decreases in weight, length, and head circumference growth. These growth impairments, particularly in repaired or complex cases, highlight potential issues with growth regulation in infants with CHD.

Area of Science:

  • Pediatric Cardiology
  • Developmental Pediatrics
  • Growth Monitoring

Background:

  • Congenital heart disease (CHD) affects a significant number of newborns.
  • Understanding growth patterns in children with CHD is crucial for long-term health outcomes.
  • Previous studies have indicated potential growth challenges in this population.

Purpose of the Study:

  • To characterize and quantify growth trajectories in young children diagnosed with congenital heart disease.
  • To compare growth patterns between different categories of CHD (single ventricle, complex repair, simple repair, no repair) and controls.
  • To identify the timing and magnitude of growth deviations in relation to CHD severity and interventions.

Main Methods:

  • Retrospective matched cohort study design.
  • Inclusion of 856 children with CHD and 10:1 matched controls from a large primary care network.
  • Analysis of World Health Organization (WHO) z scores for weight-for-age (WFAZ), length-for-age (LFAZ), weight-for-length (WFLZ), and head circumference-for-age (HCFAZ) stratified by CHD category.

Main Results:

  • Children with single ventricle (SV), complex repair (CR), and simple repair (SR) CHD experienced significant, early decreases in WFAZ and LFAZ starting within the first month of life.
  • These growth deficits peaked around 4 months and persisted through 24-36 months.
  • Head circumference-for-age (HCFAZ) decreases generally mirrored WFAZ and LFAZ trends in the SV, CR, and SR groups.

Conclusions:

  • Young children with CHD exhibit early, simultaneous reductions in growth across weight, length, and head circumference.
  • The findings suggest a potential role for dysregulated growth mechanisms in the pathophysiology of growth impairment in CHD.
  • Early identification and monitoring of growth are essential for children with congenital heart disease.
Abstract

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