Somatic growth in children with congenital heart disease at 10 years of age: Risk factors and longitudinal growth

Abstract

Background: Children with congenital heart disease (CHD) are at risk of impaired growth.

Aims: To describe height, weight, head circumference (HC), and body mass index (BMI) at 10 years and identify risk factors for altered longitudinal growth in children with CHD.

Study design: Growth parameters were evaluated from birth until 10 years using z-scores. The impact of cardiac and noncardiac factors on longitudinal growth was investigated.

Subjects: A total of 135 children with different types of CHD who underwent cardiopulmonary bypass surgery, no genetic disorder.

Outcome measures: Head circumference, weight, height and BMI.

Results: At 10 years, z-scores for height and BMI did not differ from the Swiss population (P > 0.1). Z-scores for weight and HC were significantly below the norm (-0.38 and - 0.71, P < 0.01). From 1 to 10 years, all growth parameters except BMI increased significantly (P ≤ 0.001, BMI: P = 0.14). Lower gestational age and longer length of hospitalization were associated with either impaired head circumference or length at 10 years, while lower socioeconomic status was associated with higher BMI and weight at 10 years (all P < 0.05).

Conclusion: Despite partial catch-up, somatic growth remains impaired in children with CHD with weight and HC below the norm at 10 years. The only cardiac factor associated with impaired longitudinal growth was duration of hospital stay. Furthermore, lower socioeconomic background may pose a risk of overweight at older age. Close monitoring of growth parameters and parental counselling in all CHD children is advisable beyond early childhood to ensure optimal somatic growth.

Keywords: Body mass index; Congenital heart disease; Longitudinal growth; Risk factors; School-age; Somatic growth.