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Published on: July 18, 2014
Long-term growth of children with autoantibody-mediated congenital heart block
Amanda Skog1, Håkan Eliasson, Joanna Tingström
1Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Insights
Children with congenital heart block (CHB) experience growth restriction from birth to age 11, even with pacemaker treatment. This growth deficit is more significant than maternal factors, underscoring the need for ongoing nutritional and growth monitoring.
Area of Science:
- Pediatrics
- Cardiology
- Genetics
Background:
- Congenital heart block (CHB) is associated with maternal anti-Ro/SSA antibodies.
- The impact of CHB on long-term growth requires further investigation.
Purpose of the Study:
- To analyze the growth patterns of children with and without CHB from birth to 18 years.
- To compare growth in CHB patients born to anti-Ro/SSA positive mothers with their unaffected siblings.
Main Methods:
- Population-based cohort study of Swedish CHB patients (siblings with n=72, without n=60) born 1973-2009.
- Retrieved and analyzed growth data from birth to 18 years from child healthcare and school health records.
Main Results:
- Children with CHB showed weight retardation (0.75-1.0 SD) from birth to 2-3 years, catching up by 9-11 years.
- CHB patients exhibited persistent height and weight retardation compared to unaffected siblings.
- Pacemaker treatment did not correlate with growth catch-up.
Conclusions:
- CHB is a stronger predictor of growth restriction than maternal rheumatic disease or fetal anti-Ro/SSA exposure.
- Growth restriction in CHB persists for years, emphasizing the need for nutritional and growth follow-up.
- Pacemaker treatment does not fully mitigate growth deficits in CHB patients.
Aim:
To analyse growth of children with and without congenital heart block (CHB) born to anti-Ro/SSA positive mothers from birth to 18 years of age, using a population-based cohort of Swedish CHB patients.
Methods:
Medical records for siblings with (n = 72) and without (n = 60) CHB born 1973-2009 to anti-Ro/SSA positive mothers were retrieved from child healthcare centres and school health services and used to extract data on growth from birth to 18 years.
Results:
Compared with reference standards, children with CHB were retarded in weight by 0.75-1.0 SD from birth to 2-3 years of age. Thereafter, the CHB children started to catch up, reaching the reference standards at 9-11 years of age. Pacemaker treatment was not correlated with the catch-up in growth. Individuals with CHB were retarded in both weight and height from birth to 9-11 years of age when compared to siblings without CHB, who did not demonstrate restriction in these measurements.
Conclusion:
Presence of CHB is a more important predictor of growth restriction than maternal rheumatic disease and foetal anti-Ro/SSA exposure. The restriction persists for several years after birth, despite pacemaker treatment, which highlights the importance of follow-up of children with CHB regarding nutrition and growth.
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