Factors Associated with Growth in a Cohort of Children with Complex Biventricular Congenital Heart Disease.

Autor: Teng C; Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA. Electronic address: Christopher.Teng@cardio.chboston.org., Shu D; Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA; Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA., Faerber JA; Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia, PA., Goldenring J; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Butto A; Sibley Heart Center, Children's Healthcare of Atlanta, Atlanta, GA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA., Tam V; Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia, PA., Olsen R; Center for Healthcare and Quality Analytics, Children's Hospital of Philadelphia, Philadelphia, PA., Glatz AC; Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Cohen MS; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2024 Apr; Vol. 267, pp. 113901. Date of Electronic Publication: 2024 Jan 03.
DOI: 10.1016/j.jpeds.2024.113901
Abstrakt: Objectives: To evaluate patterns and determinants of longitudinal growth among children requiring complex biventricular repair for congenital heart disease, as well as to assess for associations of growth with early feeding modality, comorbidities, postoperative complications, and socioeconomic characteristics.
Study Design: A single-institution retrospective cohort study was performed in children born February 1999 to March 2009 with complex congenital heart disease who underwent biventricular repair before age 4 years, defined by Risk Adjustment in Congenital Heart Surgery-1 category 3-5. Clinical characteristics, height, weight, and body mass index (BMI) from ages 2-12 years were collected by chart review. Neighborhood-level socioeconomic data were identified using a geographic information system approach. The adjusted association of covariates with growth outcomes was estimated using multivariable linear regression models using generalized estimating equations.
Results: Compared with population growth curves, the cohort (n = 150) trended toward early decrease in age-adjusted weight and height. Early tube feeding was significantly associated with decreased BMI before adolescence (-0.539; 95% CI -1.02, -0.054; P = .029). In addition, other clinical and perioperative characteristics had significant associations with growth, including low birth weight, preoperative tube feeds, need for multiple bypass runs, and diagnosis of feeding disorder.
Conclusions: Early childhood growth in children with complex biventricular repair may be impaired. Early tube feeding was associated with decreased BMI over the course of early childhood, which may indicate a need for continued close nutrition follow-up and support even beyond the duration of tube feeds.
Competing Interests: Declaration of Competing Interest This work was supported, in part, by the Cardiac Center Clinical Research Core at the Children's Hospital of Philadelphia. The sponsor had no direct role in study design; data collection, analysis, and interpretation; writing of the manuscript; or decision to submit the manuscript. The authors have no conflicts of interest relevant to this article to disclose.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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