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Long-term growth of children with congenital heart disease: a retrospective study
F M Schuurmans1, C F Pulles-Heintzberger, W J Gerver
1Department of Pediatrics, University Hospital of Maastricht, Maastricht University, The Netherlands.
Insights
Children with congenital heart disease (CHD) experience catch-up growth after surgery. This growth is linked to how severe their initial growth problems were, not their age at operation.
Area of Science:
- Pediatric Cardiology
- Growth and Development
- Congenital Heart Disease
Background:
- Congenital heart disease (CHD) can significantly impact a child's long-term growth and development.
- Understanding factors influencing postsurgical growth is crucial for managing children with CHD.
Purpose of the Study:
- To evaluate the long-term growth patterns of children following surgical correction for isolated CHD.
- To investigate the relationship between postsurgical catch-up growth and the severity of preoperative growth failure.
- To determine if the age at operation influences catch-up growth in children with CHD.
Main Methods:
- Retrospective study analyzing growth data from 123 children with isolated CHD.
- Calculation and plotting of mean z-scores for weight, height, and weight-for-height.
- Analysis of pre- and postoperative growth periods to assess catch-up growth.
Main Results:
- Children with conditions like large Ventricular Septal Defect (VSD) or Tetralogy of Fallot showed abnormal growth that improved but did not normalize post-surgery.
- Catch-up growth for length was strongly correlated with the severity of preoperative growth failure (r = 0.92, p < 0.05).
- Age at operation was not significantly correlated with catch-up growth (r = 0.20, NS).
Conclusions:
- Surgical correction facilitates catch-up growth in the majority of children with CHD.
- The degree of initial growth disturbance is a key predictor of postsurgical catch-up growth.
- Age at the time of surgical intervention does not appear to influence the extent of catch-up growth.
Abstract:
This retrospective study evaluates long-term growth of children with congenital heart disease (CHD) and looks for possible relationships between postsurgical catch-up growth and both severity of preoperative growth failure and operation age. Growth data of 123 children with isolated CHD were available. Mean z-scores and 95% confidence intervals for weight, height and weight-for-height were plotted for age-periods as well as for pre- and postoperative periods. Growth of children with a large VSD or a Tetralogy of Fallot was most abnormal and improved but did not normalize after operation. Catch-up growth for length was strongly correlated with severity of the preoperative growth failure (r = 0.92, p < 0.05) but not with operation age (r = 0.20, NS). We conclude that surgical correction results in catch-up growth for most individuals. Catch-up growth is positively correlated with the severity of the initial growth disturbance and not with age at the moment of surgical correction.