Child Development Center, University Children's Hospital Zurich, Switzerland.
Children's Research Center, University Children's Hospital Zurich, Switzerland; Pediatric Cardiology, Pediatric Heart Center, University Children's Hospital Zurich, Switzerland.
Early Hum Dev. 2021 May;156:105349. doi: 10.1016/j.earlhumdev.2021.105349. Epub 2021 Mar 10.
Children with congenital heart disease (CHD) are at risk of impaired growth.
To describe height, weight, head circumference (HC), and body mass index (BMI) at 10 years and identify risk factors for altered longitudinal growth in children with CHD.
Growth parameters were evaluated from birth until 10 years using z-scores. The impact of cardiac and noncardiac factors on longitudinal growth was investigated.
A total of 135 children with different types of CHD who underwent cardiopulmonary bypass surgery, no genetic disorder.
Head circumference, weight, height and BMI.
At 10 years, z-scores for height and BMI did not differ from the Swiss population (P > 0.1). Z-scores for weight and HC were significantly below the norm (-0.38 and - 0.71, P < 0.01). From 1 to 10 years, all growth parameters except BMI increased significantly (P ≤ 0.001, BMI: P = 0.14). Lower gestational age and longer length of hospitalization were associated with either impaired head circumference or length at 10 years, while lower socioeconomic status was associated with higher BMI and weight at 10 years (all P < 0.05).
Despite partial catch-up, somatic growth remains impaired in children with CHD with weight and HC below the norm at 10 years. The only cardiac factor associated with impaired longitudinal growth was duration of hospital stay. Furthermore, lower socioeconomic background may pose a risk of overweight at older age. Close monitoring of growth parameters and parental counselling in all CHD children is advisable beyond early childhood to ensure optimal somatic growth.
患有先天性心脏病（CHD）的儿童存在生长受损的风险。
描述患有 CHD 儿童 10 岁时的身高、体重、头围（HC）和体重指数（BMI），并确定影响 CHD 儿童纵向生长的危险因素。
使用 z 分数评估从出生到 10 岁的生长参数。研究了心脏和非心脏因素对纵向生长的影响。
共纳入 135 名接受心肺旁路手术的不同类型 CHD 患儿，无遗传疾病。
头围、体重、身高和 BMI。
10 岁时，身高和 BMI 的 z 分数与瑞士人群无差异（P＞0.1）。体重和 HC 的 z 分数显著低于正常值（-0.38 和-0.71，P＜0.01）。从 1 岁到 10 岁，除 BMI 外，所有生长参数均显著增加（P≤0.001，BMI：P=0.14）。较低的胎龄和较长的住院时间与 10 岁时的头围或身长受损有关，而较低的社会经济地位与 10 岁时的 BMI 和体重较高有关（均 P＜0.05）。
尽管存在部分追赶生长，但 CHD 儿童在 10 岁时仍存在体重和 HC 低于正常值的生长受损情况。与纵向生长受损唯一相关的心脏因素是住院时间。此外，较低的社会经济背景可能会增加儿童超重的风险。在幼儿期之后，建议所有 CHD 患儿密切监测生长参数并为家长提供咨询，以确保最佳的躯体生长。
