Growth Restriction in Infants and Young Children with Congenital Heart Disease.
OBJECTIVE
The purpose of this study was to determine the prevalence of growth restriction in infants and young children with congenital heart disease (CHD) and investigate the relationship between poor growth, feeding difficulties, cardiac classification, and nutrition intervention on outcomes.


METHODS
This is a prospective observational cohort study of infants and young children with CHD aged 0-3 years admitted to hospital for cardiac surgery. Anthropometry, growth history, cardiac classification, cardiac diagnosis, feeding difficulty, and nutrition intervention data were collected for 78 participants.


RESULTS
Many participants demonstrated growth restriction as evidenced by a z-score ≤ -2 for population growth parameters including weight/age z-score (n = 18, 23%), height/age z-score (n = 16, 21%), and weight/height z-score (n = 12, 18%). Increased hospital length of stay was associated with factors including faltering growth preadmission (P = .009), tube feeding required preadmission (P = .002), diagnosis of cyanotic CHD (P = .015), and presence of a feeding difficulty (P = .015).


CONCLUSIONS
Growth restriction remains an ongoing problem in children with CHD. Faltering growth preadmission and lower growth parameters were associated with an increased hospital length of stay. Nutritional screening from diagnosis may detect growth faltering, improve access to early nutrition intervention, and improve patient outcomes.
Department of Nutrition & Dietetics, Mater Children's Hospital, Herston, Queensland, Australia.
Claire L
CL
Costello
Department of Speech Pathology, Mater Children's Hospital, Herston, Queensland, Australia.
Marcelee
M
Gellatly
Department of Speech Pathology, Mater Children's Hospital, Herston, Queensland, Australia.
Jane
J
Daniel
Queensland Paediatric Cardiac Service, Mater Children's Hospital, Herston, Queensland, Australia.
Robert N
RN
Justo
Speech Pathology Department, Royal Children's Hospital, Herston, Queensland, Australia.|Discipline of Paediatrics & Child Health, The University of Queensland, Herston, Queensland, Australia.|Queensland Children's Medical Research Institute, The University of Queensland, Herston, Queensland, Australia.
Kelly
K
Weir
D000367:Age Factors; D001827:Body Height; D049628:Body Size; D001835:Body Weight; D006348:Cardiac Surgical Procedures; D002657:Child Development; D015362:Child Nutrition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D002675:Child, Preschool; D005247:Feeding Behavior; D005260:Female; D006130:Growth Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D007228:Infant Nutrition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D009752:Nutritional Status; D018529:Nutritional Support; D010343:Patient Admission; D015995:Prevalence; D011446:Prospective Studies; D011793:Queensland / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
Congenital Heart Disease/Defects; Dysphagia; Feeding Difficulty; Growth; Infant/Child; Nutrition