ObjectiveTo evaluate the height and weight development of children with congenital heart
disease undergoing surgery with the goal of determining when they reach the
threshold of normal development and whether there are differences between patients
with developmental pattern below the level of normality preoperatively
(z-score<-2 for the analyzed parameter) in comparison to the total group of
cardiac patients.MethodsWe prospectively followed up 27 children undergoing operation into five time
periods: preoperatively and at four subsequent outpatient appointments:
1st month, 3rd month, 6th month and
12th month after hospital discharge. The anthropometric parameters
used were median z-score (MZ), weight (WAZ), height (HAZ), subscapular skinfold
(SSFAZ), upper arm circumference (UAC) and triceps skinfold (TSFAZ). The evolution
assessment of the parameters was performed by analysis of variance and comparison
with the general normal population from unpaired t test, both in the total group
of cardiac patients, and in subgroups with preoperative parameters below the
normal level (Zm<-2).ResultsIn the total group there was no significant evolution of MZ of all parameters. WAZ
was statistically lower than the normal population until the 1st month
of follow-up (P=0.028); HAZ only preoperatively
(P=0.044), SSFAZ in the first month (P=0.015)
and at 12th month (P=0.038), UAC and TSFAZ were always
statistically equal to the general population. In patients whose development was
below the level of normality, there were important variation of WAZ
(P=0.002), HAZ (P=0.001) and UAC
(P=0.031) after the operation, and the WAZ was lower than the
normal population until the 3rd month (P=0.015); HAZ
and UAC, until the first month (P=0.024 and
P=0.039 respectively), SSFAZ, up to the 12th month
(P=0.005), the TSFAZ only preoperatively
(P=0.011).ConclusionThe operation promoted the return to normalcy for those with heart disease in
general within up to three months, but for the group of patients below normal
developmental pattern of the return occurred within 12 months.