Early growth Trajectory of Infants With Simple Congenital Heart Disease and Complex Congenital Heart Disease Undergoing Cardiac Repair: A Prospective Cohort Study in China

BACKGROUND We aimed to evaluate the growth trajectory of infants with congenital heart disease (CHD) and to analyze the effects of disease classification on their growth trajectory. METHODS A prospective cohort of infants with CHD was enrolled and divided into 2 groups: simple CHD (SC) and complex CHD (CC) groups. All patients were followed up for 6 months after CHD surgery. Weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), and head circumference-for-age (HCAZ) were compared between the two groups using mixed-effects linear regression. RESULT Between September 2018 and November 2019, 801 patients were followed up. The change trend in the growth Z score at first increased and then decreased from birth to 6 months postoperatively. Mixed-effects linear regression models indicated that the postoperative WAZ and WLZ scores of the CC group were lower than those of the SC group after adjustment (WAZ: β-0.72, 95% confidence interval (CI) -1.37 to -0.07, P = 0.03, WLZ: β-0.93, 95% CI -1.67 to - 0.19, P = 0.01). The models also showed an interaction effect between disease classification and preoperative growth status on infant growth outcome (WAZ: interaction β-0.48, 95% CI -0.88 to -0.07, P = 0.02, WLZ: interaction β-0.36, 95% CI -0.60 to -0.12, P = 0.004, LAZ: interaction β-0.29, 95% CI -0.56 to -0.02, P = 0.04). Subgroup analysis showed that the postoperative growth trajectory was different for infants with different birth outcomes. CONCLUSIONS Compared with SC children, CC children have deficits in their early growth trajectories. The type of disease and preoperative growth status synergistically affect the early postoperative growth trajectory. This article is protected by copyright. All rights reserved.