Allen LH

Hart DW

McCrary AW

Mroczek T

World Health Organization (WHO) Multicentre Growth Reference Study Group

Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease


            Background
            We sought to characterize growth between birth and age 3 years in infants with hypoplastic left heart syndrome who underwent the Norwood procedure.
          
          
            Methods and Results
            
              We performed a secondary analysis using the Single Ventricle Reconstruction Trial database after excluding patients &lt;37 weeks gestation (N=498). We determined length‐for‐age
              z
              score (
              LAZ
              ) and weight‐for‐age
              z
              score (
              WAZ
              ) at birth and age 3 years and change in
              WAZ
              over 4 clinically relevant time periods. We identified correlates of change in
              WAZ
              and
              LAZ
              using multivariable linear regression with bootstrapping. Mean
              WAZ
              and
              LAZ
              were below average relative to the general population at birth (
              P
              &lt;0.001,
              P
              =0.05, respectively) and age 3 years (
              P
              &lt;0.001 each). The largest decrease in
              WAZ
              occurred between birth and Norwood discharge; the greatest gain occurred between stage
              II
              and 14 months. At age 3 years,
              WAZ
              and
              LAZ
              were &lt;−2 in 6% and 18%, respectively. Factors associated with change in
              WAZ
              differed among time periods. Shunt type was associated with change in
              WAZ
              only in the Norwood discharge to stage II period; subjects with a Blalock‐Taussig shunt had a greater decline in
              WAZ
              than those with a right ventricle‐pulmonary artery shunt (
              P
              =0.002).
            
          
          
            Conclusions
            
              WAZ
              changed over time and the predictors of change in
              WAZ
              varied among time periods. By age 3 years, subjects remained small and three times as many children were short as were underweight (&gt;2
              SD
              below normal). Failure to find consistent risk factors supports the strategy of tailoring nutritional therapies to patient‐ and stage‐specific targets.
            
          
          
            Clinical Trial Registration
            
              URL:
              http://clinicaltrials.gov/
              . Unique identifier: NCT00115934.
            
          </jats:sec

Phillip T. Burch

Eric Gerstenberger

Chitra Ravishankar

David A. Hehir

Ryan R. Davies

Steven D. Colan

Lynn A. Sleeper

Jane W. Newburger

Martha L. Clabby

Ismee A. Williams

Jennifer S. Li

Karen Uzark

David S. Cooper

Linda M. Lambert

Victoria L. Pemberton

Nancy A. Pike

Jeffrey B. Anderson

Carolyn Dunbar‐Masterson

Svetlana Khaikin

Sinai C. Zyblewski

L. LuAnn Minich

null null

Crossref

Journal of the American Heart Association

Longitudinal Assessment of Growth in Hypoplastic Left Heart Syndrome: Results From the Single Ventricle Reconstruction Trial

Longitudinal Assessment of Growth in Hypoplastic Left Heart Syndrome: Results From the Single Ventricle Reconstruction Trial

Abstract

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