Early Growth Trajectory of Infants With Simple Congenital Heart Disease and Complex Congenital Heart Disease Undergoing Cardiac Repair: A Prospective Cohort Study in China

Abstract

Background We aimed to evaluate the growth trajectory of infants with congenital heart disease (CHD) and to analyze the effects of disease classification on their growth trajectory. Methods A prospective cohort of infants with CHD was enrolled and divided into 2 groups: simple CHD (SC) and complex CHD (CC) groups. All patients were followed up for 6 months after CHD surgery. Weight for age (WAZ), length for age (LAZ), weight for length (WLZ), and head circumference for age were compared between the 2 groups using mixed‐effects linear regression. Result Between September 2018 and November 2019, 801 patients had data collected. The z‐score trend decreased (e.g., ΔWAZ: 1.29±1.44) and then increased (e.g., ΔWAZ: 1.06±1.13), and all z‐scores were below 0 from birth to 6 months postoperatively. Mixed‐effects linear regression models indicated that the postoperative WAZ and WLZ scores of the CC group were lower than those of the SC group after adjustment (WAZ: β = −0.72; 95% confidence interval [CI], −1.37 to −0.07; P = .03) (WLZ: β = −0.93, 95% CI, −1.67 to −0.19; P = .01). The models also showed an interaction effect between disease classification and preoperative growth status on infant growth outcome (WAZ: interaction β = −0.48; 95% CI, −0.88 to −0.07; P = .02) (WLZ: interaction β = −0.36; 95% CI, −0.60 to −0.12; P = .004) (LAZ: interaction β = −0.29; 95% CI, −0.56 to −0.02; P = .04). Conclusions Compared with SC children, CC children have deficits in their early growth trajectories. The type of disease and preoperative growth status synergistically affect the early postoperative growth trajectory.

Health-related quality of life in children with congenital heart disease following interventional closure versus minimally invasive closure

“…The literature suggests that severe CHD affects physical, cognitive, and neurological development which, in turn, affects the HRQL of children ( 27 , 28 ). In our study, all children underwent successful septal defect repairs, and only 17 (8.5%) had postoperative residual shunts of 2–3 mm, which either closed spontaneously or were < 2 mm 6 months after surgery.…”

Evaluation of neurodevelopmental impairments and risk factors in children following cardiac surgery: The first cohort from China

“… 35 This problem is further compounded by the complex metabolic alterations with hypermetabolism and hypercatabolism during the early postoperative course and is persistent through the first 6 months after operation. 36 Adequate nutrition with breast milk feeding in these children may be even more significant to improve their neurodevelopment outcomes.…”