title: Growth Trajectory in Children with Trisomy 21 with and without Atrioventricular Septal Defect.
abstract: OBJECTIVE
  Trisomy 21 is associated with poor weight gain and atrioventricular septal defects. The impact of atrioventricular septal defects on weight gain in the setting of Trisomy 21 has not previously been described in the recent era. This study aimed to determine if such an association is present.
  
  
  METHODS
  Patients with Trisomy 21 with and without atrioventricular septal defects were identified. Clinical, surgical, and postoperative data were collected were for these patients and then compared between patients. Specifically, weight for age z-scores were compared at various time points in a univariate and multivariate fashion. Effect of timing of surgery in those with an atrioventricular septal defect was also studied.
  
  
  RESULTS
  A total of 86 patients were identified, 42 with an atrioventricular septal defect. There was a difference in weight for age z-scores between patients with and without atrioventricular septal defects only at 2 months (P value .038) and 6 months (P value .003) of age. This persisted after multivariate regression which demonstrated atrioventricular septal defects as an independent risk factor. There was no difference noted in weight at 2 years of age in patients undergoing atrioventricular septal defect repair before and 150 days of life.
  
  
  CONCLUSIONS
  There was a statistically significant, but not clinically relevant, difference in weight between the patients with Trisomy 21 with and without atrioventricular septal defects in our cohort. Those with atrioventricular septal defects required more nutritional intervention, such as gastrostomy tube placement. Timing of repair did not alter outcomes at midterm follow-up.
authors.affiliation: Pediatric Cardiology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wis, USA.
authors.forename: Chad A
authors.initials: CA
authors.lastname: Mackman
authors.affiliation: Pediatric Cardiology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wis, USA.
authors.forename: Rohit S
authors.initials: RS
authors.lastname: Loomba
authors.affiliation: Pediatric Cardiology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wis, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Slicker
authors.affiliation: Pediatric Cardiology, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wis, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bartz
mesh_terms: D000367:Age Factors; D006348:Cardiac Surgical Procedures; D016009:Chi-Square Distribution; D002657:Child Development; D002675:Child, Preschool; D004314:Down Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D057286:Electronic Health Records; D005260:Female; D006343:Heart Septal Defects / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009752:Nutritional Status; D018529:Nutritional Support; D012189:Retrospective Studies; D013997:Time Factors; D015430:Weight Gain
keywords: Atrioventricular Canal; Atrioventricular Septal Defect; Down Syndrome; Growth; Trisomy 21