title: Determinants of body weight gain and association with neurodevelopmental outcome in infants operated for congenital heart disease.
abstract: The aim of this prospective study was to examine the determinants of growth failure and the association with neurodevelopmental outcome in infants undergoing open-heart surgery. In 107 infants undergoing open-heart surgery for congenital heart disease (CHD), we evaluated weight at birth, at surgery, and at one year of age (expressed as z-scores). Neurodevelopmental status was assessed before surgery and at one year of age. Median age at surgery was 3.9 months (range: 0.1-10.2). Mean [+/-standard deviation (S.D.)] weight z-score at birth was -0.27 (+/-1.45), before surgery -1.34 (+/-1.45) (P<0.001 vs. birth weight), and at one year -0.86 (+/-1.35), (P<0.001 vs. weight at surgery). Poor preoperative weight (<10th percentile) was associated with genetic disorders [odds ratio (OR) 5.9, P<0.001], preoperative neurological abnormalities (OR 3.41, P<0.05), and older age at surgery (OR 1.01, P<0.05). Weight <10th percentile at one year was associated with the same factors as poor preoperative weight, however, also with risk adjustment for congenital heart surgery-1 (RACHS) score >3 (OR 3.22, P<0.05). Neurodevelopmental outcome at one year was not determined by growth failure. In conclusion, impaired body weight gain before surgery is followed by a catch-up growth after surgery. However, there is no relationship to neurodevelopmental outcome. Genetic comorbidity is the most significant factor for poor weight gain.
authors: Division of Pediatric Cardiology, University Children's Hospital Zurich, Zurich, Switzerland. walter.knirsch@kispi.uzh.ch
authors: Walter
authors: W
authors: Knirsch
authors: Walter
authors: W
authors: Zingg
authors: Vera
authors: V
authors: Bernet
authors: Christian
authors: C
authors: Balmer
authors: Anastasia
authors: A
authors: Dimitropoulos
authors: René
authors: R
authors: Prêtre
authors: Urs
authors: U
authors: Bauersfeld
authors: Bea
authors: B
authors: Latal
mesh_terms: D000367:Age Factors; D001724:Birth Weight; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002657:Child Development; D002658:Developmental Disabilities / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D005260:Female; D030342:Genetic Diseases, Inborn / Q000150:complications / Q000503:physiopathology; D006130:Growth Disorders / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009420:Nervous System / Q000254:growth & development*; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D015430:Weight Gain / Q000235:genetics