Evaluation of growth in children with congenital heart disease

Objective: The incidence of congenital heart disease (CHD) varies from about 8/1,000 to 10/1,000 live births. Growth failure is a well-recognized complication of congenital heart disease (CHD) and still an important problem for children with CHD. Growth failure in these children cause delay in surgical correction and increased risk of morbidity postoperatively. Inadequate caloric intake, increased energy requirements, malabsorption, severity of disease and hypoxia appears to be the most important factors in growth failure of CHD. However, underlying mechanisms of growth failure is still controversial. The purpose of this study was to evaluate the correlation between anthropometric measures of children with congenital heart disease with weight/age, height/age and weight/height z-scores that represent their growth indicators. Patients and Methods: 336 children with congenital heart disease, aged 1 month-18 years (mean 30 months) old who applied to the Inonu University Medical Faculty Department of Pediatric Cardiology between January 2013- June 2016 were evaluated. Patients with congenital malformations, dysmorphic syndromes, chromosomal diseases, serious infections, hypothyroidism and additional illness causing growth retardation were excluded. We measured the height and weight of all patients, and calculated height/age, weight/age, and weight/height z-scores. Results: Of the 336 patients evaluted, 232(%69) patients had left to right shunt heart disease, 48(%14,3) patients had cyanotic and 56(%16,7) patients had obstructive congenital heart disease. 67(%29,8) patients of the left to right congenital heart disease group, 28(%58,3) patients of the cyanotic heart disease group and 119(%36,2) patients of obstructive congenital heart disease group had heiht/age z-scores under -2. 66(%28,9) patients of the left to right shunt congenital heart disase group, 23(%47,9) patients of the cyanotic congenital heart disease group and 107(%32,3) patients of obstructive congenital heart disease group had weight/age z-scores under -2. 26(%18,2) patients of the left to right shunt congenital heart disase group, 7(%16,7) patients of the cyanotic heart disease group and 7(%18,9 ) patients of obstructive congenital heart disease group had weight/height z-score under -2. Conclusion: Cardiovascular malformations is a common type of congenital malformations. Growth restriction remains an ongoing problem in children with CHD. Nutritional screening from diagnosis may detect growth faltering, improve access to early nutrition intervention, and improve patient outcomes. Key Words; Congenital heart disease, growth failure.