title: Growth in children with congenital heart disease.
abstract: OBJECTIVE
  We sought to describe growth in young children with congenital heart disease (CHD) over time.
  
  
  METHODS
  We performed a retrospective matched cohort study, identifying children with CHD in a large primary care network in Pennsylvania, New Jersey, and Delaware and matching them 10:1 with control subjects. The primary endpoint was the difference in mean World Health Organization z score for cases and controls for weight-for-age (WFAZ), length-for-age (LFAZ), weight-for-length (WFLZ), and head circumference-for-age (HCFAZ) at traditional ages for preventive visits, stratified by CHD category.
  
  
  RESULTS
  We evaluated 856 cases: 37 with single ventricle (SV) physiology, 52 requiring complex repair (CR), 159 requiring simple repair (SR), and 608 requiring no repair. For children in the SV, CR, and SR categories, large, simultaneous, and statistically significant (Student's t test P < .05) decreases in WFAZ and LFAZ appeared within the first month of life, peaked near 4 months, and persisted through 24 or 36 months. There were fewer and smaller decreases in the no-repair group between 2 and 18 months. HC data were available between 1 week and 24 months; at those ages, decreases in mean HCFAZ generally paralleled decreases in WFAZ and LFAZ in the SV, CR, and SR groups.
  
  
  CONCLUSIONS
  Children with CHD experience early, simultaneous decreases in growth trajectory across weight, length, and head circumference. The simultaneous decrease suggests a role for altered growth regulation in children with CHD.
authors.affiliation: Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada. cdaymont@mich.ca
authors.forename: Carrie
authors.initials: C
authors.lastname: Daymont
authors.forename: Ashley
authors.initials: A
authors.lastname: Neal
authors.forename: Aaron
authors.initials: A
authors.lastname: Prosnitz
authors.forename: Meryl S
authors.initials: MS
authors.lastname: Cohen
mesh_terms: D001827:Body Height / Q000502:physiology*; D001835:Body Weight / Q000502:physiology*; D002675:Child, Preschool; D015331:Cohort Studies; D003691:Delaware / Q000453:epidemiology; D005260:Female; D006257:Head / Q000254:growth & development*; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009515:New Jersey / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies