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Comparison of growth and feeding method in infants with and without genetic abnormalities after neonatal cardiac
Alyson R Pierick1, Trudy A Pierick2, Benjamin E Reinking2
1Emory University School of Medicine, Department of Pediatrics, Atlanta, GA, USA.
Insights
Infants with congenital heart disease (CHD) and genetic abnormalities experience slower oral feeding post-surgery. Growth outcomes were similar, but genetic factors impact feeding progression in these high-risk infants.
Area of Science:
- Pediatric Cardiology
- Genetics
- Neonatal Surgery
Background:
- Congenital heart disease (CHD) arises from genetic and environmental factors, often causing growth delays in infants.
- The combined impact of genetic abnormalities and CHD on infant growth requires further investigation.
Purpose of the Study:
- To compare infant growth and feeding methods after neonatal cardiac surgery.
- To analyze differences between infants with normal versus abnormal genetic testing.
Main Methods:
- Retrospective chart review of neonates undergoing Risk Adjustment in Congenital Heart Surgery (RACHS) IV-VI procedures.
- Collected anthropometric data (weight, length, head circumference) and feeding methods from birth to 6 months post-surgery.
Main Results:
- Of 53 infants, 22 had abnormal genetic testing; 90% were discharged with supplemental tube feeds.
- Infants with normal genetics showed a trend towards earlier oral feeding (80% at 5 months) compared to those with abnormal genetics (60%), though not statistically significant.
- No significant differences in growth (weight, length, head circumference) were observed between groups.
Conclusions:
- Infants with critical CHD, with or without genetic abnormalities, are prone to growth delays and require post-operative tube feeding.
- Genetic abnormalities are associated with delayed oral feeding progression and increased reliance on tube feedings.
- Systematic management protocols are crucial for high-risk infants with CHD and genetic abnormalities.
Introduction:
Congenital heart disease (CHD) is multifactorial in origin, resulting from an interaction between environmental and genetic factors. Multifactorial growth delay is common in infants with CHD. The impact of a genetic abnormality and CHD on the growth of an infant is lacking in the literature. The aim of this study is to compare the growth and method of feeding following neonatal cardiac surgery in infants with normal versus abnormal genetic testing.
Methods:
A retrospective chart review of neonates who underwent a Risk Adjustment in Congenital Heart Surgery IV-VI procedure between 1 January, 2006 and 22 September, 2016 was performed at our institution. Weight, length, head circumference measurements, and feeding method were collected at birth, time of neonatal surgery, and monthly up to 6 months of age.
Results:
A total of 53 infants met inclusion criteria, of which 22 had abnormal genetic testing. Approximately 90% of infants were discharged following neonatal cardiac surgery with supplemental tube feeds. At each monthly follow-up visit, more infants were exclusively fed orally: 80% of infants with normal genetics at 5 months post-operative follow-up versus 60% of infants with abnormal genetic testing, although statistically insignificant. Growth was not different among the two groups.
Conclusions:
Infants with critical CHD with or without genetic abnormalities are at risk for growth delays and many need supplemental tube feeds post-operatively and throughout follow-up. Infants with genetic abnormalities are slower to achieve oral feeds and more likely to require tube feedings. It is important to have a systematic protocol for managing these high-risk infants.
