Table of Contents

HK J Paediatr (New Series)
Vol 2. No. 2, 1997

HK J Paediatr (New Series) 1997;2:182

Proceedings of Scientific Meeting

Gender Differences in Growth Pattern in Children with Congenital Heart Disease

Esther GJ Jacobs, Maurice P Leung, Johan Karlberg

HK J Paediatr (new series) 1997;2:175-186

Hong Kong Paediatric Society 35th Anniversary Scientific Meeting September 6,1997

Introduction: Infants with congenital heart disease (CHD) are more likely to be born with a low birth weight than infants without cardiac defects. In addition, patients with CHD gain less weight and height postnatally compared to healthy children of the same age. Boys tend to be more retarded in growth than girls. The aim of this study was to define the effect of gender on the degree of prenatal and postnatal growth impairment in Chinese children with CHD.

Materials and Methods: The medical records of 666 children below four years of age with CHD, treated at the Paediatric Cardiac Unit, Grantham Hospital in 1994 and 1995, were studied retrospectively. The cardiac defects were classified according to their major basic physiological defect. Birth weight and weight and height at the time of operation were compared with the current growth reference in Hong Kong.

Results: At birth 17% of the patients in the total study population had a birth weight lying below -2 SDS. Boys (20%) were significantly more affected in growth than girls (13%) (p<0.05). This gender difference in birth weight was not found for any specific cardiac defect. At the time of surgery 38% and 41% of the total population, respectively, had weight and height values below -2 SDS. Low values were found for 43% (weight) and 41% (height) of the girls in contrast with 32% (weight) and 41% (height) for the boys (p<0.05 for weight). Analysis of the specific cardiac defects showed that girls suffering from a ventricular septal defect were significantly more affected in weight and weight-for-height than boys; 75% and 52% of the girls had weight and weight-for-height values, respectively, below -2 SDS compared to 50% and 27%, respectively, for the boys (p<0.05). In addition, girls with transposition of the great arteries had a significantly higher proportion of weight values lying below -2 SDS (50%) than boys (6%) (p<0.05). The mean age at operation was comparable for the two sexes both in the total study population as for the specific cardiac defects (p>0.05).

Conclusions: These results suggest that while boys with CHD are more prone to be born with a low birth weight, girls seem to be more affected in growth at the time of surgical intervention. This gender difference in growth retardation is particularly evident within the group of children with ventricular septal defect and transposition of the great arteries. As the mean age at operation was similar for the two sexes, this should possibly not be a cause accounting for the difference in growth impairment between boys and girls. Further studies would be required to identify the underlying mechanism for such a major difference.


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