Evolution of weight and height of children with congenital heart disease undergoing surgical treatment

Objective

To evaluate the height and weight development of children with congenital heartdisease undergoing surgery with the goal of determining when they reach thethreshold of normal development and whether there are differences between patientswith developmental pattern below the level of normality preoperatively(z-score<-2 for the analyzed parameter) in comparison to the total group ofcardiac patients.

Methods

We prospectively followed up 27 children undergoing operation into five timeperiods: preoperatively and at four subsequent outpatient appointments:1^st month, 3^rd month, 6^th month and12^th month after hospital discharge. The anthropometric parametersused were median z-score (MZ), weight (WAZ), height (HAZ), subscapular skinfold(SSFAZ), upper arm circumference (UAC) and triceps skinfold (TSFAZ). The evolutionassessment of the parameters was performed by analysis of variance and comparisonwith the general normal population from unpaired t test, both in the total groupof cardiac patients, and in subgroups with preoperative parameters below thenormal level (Zm<-2).

Results

In the total group there was no significant evolution of MZ of all parameters. WAZwas statistically lower than the normal population until the 1^st monthof follow-up (P=0.028); HAZ only preoperatively(P=0.044), SSFAZ in the first month (P=0.015)and at 12^th month (P=0.038), UAC and TSFAZ were alwaysstatistically equal to the general population. In patients whose development wasbelow the level of normality, there were important variation of WAZ(P=0.002), HAZ (P=0.001) and UAC(P=0.031) after the operation, and the WAZ was lower than thenormal population until the 3^rd month (P=0.015); HAZand UAC, until the first month (P=0.024 andP=0.039 respectively), SSFAZ, up to the 12^th month(P=0.005), the TSFAZ only preoperatively(P=0.011).

Conclusion

The operation promoted the return to normalcy for those with heart disease ingeneral within up to three months, but for the group of patients below normaldevelopmental pattern of the return occurred within 12 months.