Low birth weight and risk of cardiac arrhythmias in children

This study aimed to investigate a possible association between low birth weight (LBW) and other perinatal major characteristics and the risk of a child having accessory pathways of conduction tissue and cardiac arrhythmia later in life.

Thirty-one children aged 1-15 years (12 boys, 19 girls), in whom the persistence of accessory pathways of conduction tissue in the heart and inducible reciprocating supraventricular tachycardia were confirmed by means of programmable transoesophageal pacing, constituted the study group. None of them exhibited signs of either inborn or acquired heart disease causing arrhythmia, and their parents and siblings did not suffer cardiac arrhythmias. The control group was formed of 62 apparently healthy children (two controls for each case) matched to cases for sex, age, date and place of birth. Information on infant perinatal and maternal characteristics was collected retrospectively.

High risk of arrhythmia in children was associated with LBW (< 2500 g): odds ratio was equal to 14.6 (95% CI: 1.7-127.9; P = 0.015), and it remained after adjustment had been made for major potential confounders. In addition, children with arrhythmia were more often born with retarded intrauterine growth (birth weight < 10 percentile), preterm (< 37 weeks of gestation), of higher birth order, and had lower Apgar scores at 1 and 5 min. Their mothers more often had diagnosed gynaecological diseases.

Antenatal stress leading to LBW may be associated with atypical development and maturation of cardiac conduction system and increased risk of cardiac arrhythmias later in life.