MP Leung, O Howes, S Macdonald, J Karlberg

Growth impairment is a common consequence of congenital heart disease (CHD) particularly within the first two years of life. Contributing factors are low weight already at birth, inadequate nutrition, inefficient nutrient utilisation and increased energy expenditure Less is know about the influence of the age at diagnosis of the heart impairment and the timing of surgical correction on growth in early life.

For this reason the records of 139 infants with CHD treated of the Department of Paediatrics, Grantham Hospital, University of Hong Kong were reviewed retrospectively.

Most patients (n = 102) had a left to right shunt is isolation or in combination with an additional lesion. The second largest group was the right ventricular outflow obstruction group (n = 23). The mean birth weight was 3.0 kg (SD = 0.59) and the mean length of gestation was 39.4 weeks (SD = 1.8). The mean age (a) of first symptom was 0.00 year (range 0-3.00), (b) of referral 0.23 year (range 0-8.55), (c) of diagnosis 0.29 year (range 0.0-12.85) and (d) of operation 0.85 year (range 0.0-13.3). The infants as a group showed an impaired weight gain in the first three months of life of up to one standard deviation followed by an almost complete catch-up growth over the four years This growth pattern was similar for cyanotic and acyanotic and physiological defect subgroups. The timing of surgery had no obvious effect on overall weight gain over the four years but the later the surgery the greater the initial weight impairment.

Further prospective standardised studies are called for to characterise the influence of the type of lesion, symptoms and the timing of surgical correction in infants with CHD on body growth.