Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.
Pediatrics. 2013 Jan;131(1):e236-42. doi: 10.1542/peds.2012-1157. Epub 2012 Dec 10.
We sought to describe growth in young children with congenital heart disease (CHD) over time.
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.
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.
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.
我们旨在描述先天性心脏病（CHD）患儿的生长变化。
我们进行了一项回顾性匹配队列研究，在宾夕法尼亚州、新泽西州和特拉华州的一个大型初级保健网络中确定患有 CHD 的儿童，并将其与 10:1 的对照组相匹配。主要终点是 CHD 患儿和对照组在预防就诊的传统年龄段时，体重-年龄（WFAZ）、长度-年龄（LFAZ）、体重-长度（WFLZ）和头围-年龄（HCFAZ）的平均世界卫生组织 z 评分的差异，分层为 CHD 类别。
我们评估了 856 例病例：37 例患有单心室（SV）生理，52 例需要复杂修复（CR），159 例需要简单修复（SR），608 例无需修复。对于 SV、CR 和 SR 组的患儿，WFAZ 和 LFAZ 在出生后第一个月内就出现了大幅、同步且具有统计学意义的下降（Student's t 检验 P<.05），在接近 4 个月时达到峰值，并持续到 24 或 36 个月。在无需修复组中，2 至 18 个月期间的下降幅度较小。HC 数据在 1 周到 24 个月之间可用；在这些年龄段，SV、CR 和 SR 组的平均 HCFAZ 下降通常与 WFAZ 和 LFAZ 的下降相平行。
CHD 患儿的体重、长度和头围的生长轨迹均出现早期、同步的下降。这种同步下降表明生长调节的改变在 CHD 患儿中起作用。
