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Determinants of body weight gain and association with neurodevelopmental outcome in infants operated for congenital heart disease


Knirsch, W; Zingg, W; Bernet, V; Balmer, C; Dimitropoulos, A; Prêtre, René; Bauersfeld, U; Latal, B (2009). Determinants of body weight gain and association with neurodevelopmental outcome in infants operated for congenital heart disease. Interactive Cardiovascular and Thoracic Surgery, 10(3):377-382.

Abstract

The aim of this prospective study was to examine the determinants of growth failure and the association with neurodevelopmental outcome in infants undergoing open-heart surgery. In 107 infants undergoing open-heart surgery for congenital heart disease (CHD), we evaluated weight at birth, at surgery, and at one year of age (expressed as z-scores). Neurodevelopmental status was assessed before surgery and at one year of age. Median age at surgery was 3.9 months (range: 0.1-10.2). Mean [+/-standard deviation (S.D.)] weight z-score at birth was -0.27 (+/-1.45), before surgery -1.34 (+/-1.45) (p<0.001 vs. birth weight), and at one year -0.86 (+/-1.35), (p<0.001 vs. weight at surgery). Poor preoperative weight (<10th percentile) was associated with genetic disorders [odds ratio (OR) 5.9, p<0.001], preoperative neurological abnormalities (OR 3.41, p<0.05), and older age at surgery (OR 1.01, p<0.05). Weight <10th percentile at one year was associated with the same factors as poor preoperative weight, however, also with risk adjustment for congenital heart surgery-1 (RACHS) score >3 (OR 3.22, p<0.05). Neurodevelopmental outcome at one year was not determined by growth failure. In conclusion, impaired body weight gain before surgery is followed by a catch-up growth after surgery. However, there is no relationship to neurodevelopmental outcome. Genetic comorbidity is the most significant factor for poor weight gain. Keywords: Neurodevelopmental outcome; Cardiac surgery; Genetic disorders.

Abstract

The aim of this prospective study was to examine the determinants of growth failure and the association with neurodevelopmental outcome in infants undergoing open-heart surgery. In 107 infants undergoing open-heart surgery for congenital heart disease (CHD), we evaluated weight at birth, at surgery, and at one year of age (expressed as z-scores). Neurodevelopmental status was assessed before surgery and at one year of age. Median age at surgery was 3.9 months (range: 0.1-10.2). Mean [+/-standard deviation (S.D.)] weight z-score at birth was -0.27 (+/-1.45), before surgery -1.34 (+/-1.45) (p<0.001 vs. birth weight), and at one year -0.86 (+/-1.35), (p<0.001 vs. weight at surgery). Poor preoperative weight (<10th percentile) was associated with genetic disorders [odds ratio (OR) 5.9, p<0.001], preoperative neurological abnormalities (OR 3.41, p<0.05), and older age at surgery (OR 1.01, p<0.05). Weight <10th percentile at one year was associated with the same factors as poor preoperative weight, however, also with risk adjustment for congenital heart surgery-1 (RACHS) score >3 (OR 3.22, p<0.05). Neurodevelopmental outcome at one year was not determined by growth failure. In conclusion, impaired body weight gain before surgery is followed by a catch-up growth after surgery. However, there is no relationship to neurodevelopmental outcome. Genetic comorbidity is the most significant factor for poor weight gain. Keywords: Neurodevelopmental outcome; Cardiac surgery; Genetic disorders.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:05 Mar 2010 09:48
Last Modified:05 Apr 2016 14:00
Publisher:European Association of Cardio-Thoracic Surgery
ISSN:1569-9285
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1510/icvts.2009.216135
PubMed ID:19959555

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