Related Experiment Video
Updated: Jun 9, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Late Gestation Fetal Growth in Infants Undergoing Stage 1 Palliation for Single Ventricle Heart Disease
Kristin Schneider1,2, Elisa Marcuccio3,4, James F Cnota3,4
1The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 2003, Cincinnati, OH, 45229, USA. kristin.schneider@cchmc.org.
Insights
For fetuses with single ventricle heart disease needing stage 1 palliation, later gestational age (GA) is linked to decreased growth velocity but continued growth. Infants born later experienced shorter ventilation and improved outcomes after stage 1 palliation.
Area of Science:
- Pediatric Cardiology
- Fetal Development
- Congenital Heart Disease
Background:
- Single ventricle heart disease (SVHD) requires complex surgical palliation.
- Understanding fetal growth and postnatal outcomes in SVHD is crucial for optimizing delivery timing and care.
Purpose of the Study:
- To analyze late gestation fetal growth patterns in SVHD fetuses.
- To compare postnatal outcomes based on gestational age (GA) in infants with SVHD requiring stage 1 palliation (S1P).
Main Methods:
- Retrospective cohort analysis of 1290 infants from the National Pediatric Cardiology Quality Improvement Collaborative database (2016-2019).
- Inclusion criteria: GA ≥ 36 weeks, anticipated need for S1P.
- Comparison of birthweight (BW), BW z-scores, survival to stage 2 palliation (S2P), post-S1P length of stay, and mechanical ventilation duration across different gestational ages.
Main Results:
- Mean BW increased with GA (p < 0.001), but BW z-scores were below zero in late gestation.
- Growth velocity declined between 38 to >40 weeks GA.
- Infants born at later GA had shorter mechanical ventilation durations (p < 0.001), shorter S1P hospitalizations (p = 0.015), and were more likely to undergo S2P (p = 0.003).
Conclusions:
- Infants with SVHD requiring S1P exhibit decreased late gestation growth velocity, though growth persists.
- Increased gestational age at birth is associated with improved short-term postnatal outcomes, including shorter ventilation and hospitalization durations, and a higher likelihood of proceeding to S2P.
Abstract:
Improved understanding of late gestation fetal growth patterns and postnatal outcomes in fetuses with single ventricle heart disease may inform decisions about elective delivery timing. This was a retrospective cohort analysis of patients in the National Pediatric Cardiology Quality Improvement Collaborative database from 2016 to 2019 anticipated to need stage 1 palliation (S1P) and had a gestational age (GA) of ≥ 36 weeks. Birthweight (BW) and BW z-scores were compared across GA. Survival to stage 2 palliation (S2P), post-S1P length of stay, and duration of mechanical ventilation were compared by GA. In 1290 infants, the mean BW increased with increasing GA (p < 0.001). Mean BW z-scores were below zero in late gestation (p < 0.001), with declining growth velocity 38 to > 40 weeks GA. Of 1216 patients with mechanical ventilation data, those at later GA had shorter durations of ventilation (p < 0.001). Among 1083 survivors to discharge or S2P if not discharged, infants born at later GA had shorter S1P hospitalizations (p = 0.015) and were more likely to undergo S2P (p = 0.003). Infants with single ventricle heart disease requiring S1P have decreased late gestation growth velocity, but growth continues. Infants born after longer gestation have shorter duration of ventilation and greater likelihood of undergoing S2P.
