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Improving the growth of infants with congenital heart disease using a consensus-based nutritional Pathway-A follow up

Aneurin Young1, Catarina Fandinga2, Cai Davis3

  • 1Department of Neonatal Medicine, Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust, Southampton UK; Southampton NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Faculty of Medicine, University of Southampton, Southampton, UK.

Clinical Nutrition (Edinburgh, Scotland)
|April 5, 2025
PubMed

Insights

A new nutrition pathway improved growth in infants with congenital heart disease (CHD) before surgery. This intervention led to better weight gain velocity in the first year of life, potentially reducing later metabolic disease risk.

Area of Science:

  • Pediatric Cardiology
  • Nutritional Science
  • Congenital Abnormalities

Background:

  • Congenital Heart Disease (CHD) is the most common congenital abnormality, affecting 9 per 1000 live births.
  • Growth failure in infants with CHD is linked to increased mortality risk post-cardiac surgery.
  • Optimizing growth in infants with CHD awaiting surgery is crucial for reducing morbidity and improving long-term metabolic health.

Purpose of the Study:

  • To evaluate the impact of a consensus-based nutrition pathway implemented in 2017 on growth outcomes in infants with CHD.
  • To compare growth in two epochs: pre-pathway (2013-2016) and post-pathway implementation (2017-2023).

Main Methods:

  • Growth measures were extracted from electronic patient records and z-scores were calculated.
  • SuperImposition by Translation And Rotation (SITAR) models were used to create fitted growth velocity curves for each epoch.
  • A cohort of infants with CHD was analyzed across two distinct time periods.

Main Results:

  • Infants in the post-pathway group showed significantly better growth outcomes within the first 4 months of life.
  • Weight gain velocity was significantly higher in the post-implementation epoch after adjusting for group differences (p=0.01).
  • No significant change in overweight or obesity prevalence was observed at later timepoints, suggesting the pathway did not promote obesity.

Conclusions:

  • The implemented nutrition pathway was associated with improved growth in infants with CHD during the first year of life compared to previous standard care.
  • Achieving normal growth patterns early in life may mitigate the risk of developing metabolic diseases later.
  • Further research is needed to fully understand the long-term metabolic implications of improved early growth in this population.
Abstract

Keywords:
Congenital heart diseaseGrowthInfantsNutrient energy dense feedsNutrition pathway

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