Childhood growth patterns following congenital heart disease

Prenatal and early postnatal growth are known to be abnormal in patients with CHD. Although adult metabolic risk is associated with growth later in childhood, little is known of childhood growth in CHD.

Retrospective data were collected on 551 patients with coarctation of the aorta, hypoplastic left heart syndrome, single ventricle physiology, tetralogy of Fallot, transposition of the great arteries, or ventricular septal defects. Weight, height, and body mass index data were converted to Z-scores. Body size at 2 years and growth between 2 and 20 years, 2 and 7 years, and 8 and 15 years were compared with Normative data using a sequential series of mixed-effects linear models.

A total of 4660 weight, 2989 height, and 2988 body mass index measurements were analysed. Body size at 2 years of age was affected by cardiac diagnosis and gender. Abnormal growth was frequent and varied depending on cardiac diagnosis, gender, and the time period considered. The most abnormal patterns were seen in patients with tetralogy of Fallot, hypoplastic left heart syndrome, or single ventricle physiology. Potentially high-risk growth, a combination of small body size at 2 years and rapid subsequent growth, was seen in several groups.

Childhood and adolescent growth patterns were gender- and lesion-specific. Several lesions were associated with abnormal patterns of childhood growth known to be associated with an increased risk of adult adiposity or metabolic risk in other populations. Further information is needed on the long-term metabolic risks of survivors of CHD.