Physical Growth Trajectories in Children With Congenital Heart Disease: A Nationwide Study

Abstract

Background and Objectives: The growth trajectories of children diagnosed with congenital heart disease (CHD) remain unclear when analyzed through population-based data. This study examined the risk of poor growth outcomes in preschool-aged children with CHD. Methods: This study included 325,930 children born between 2007 and 2014, ofwhom 65,186 were diagnosed with CHD (1,026 with complex, 2,073 with moderate, and 62,087 with simple CHD). Growth Z-scores (height, weight, head circumference, and body mass index) were measured through the National Health Screening Program for Infants and Children, which is conducted annually for children aged six months to six years. Participants were observed until death or December 31, 2020, whichever occurred first. Results: Overall, there were 1,390 deaths in the CHD group, with a cumulative survival rate of 97.9%. Growth deficits were most pronounced in the complex CHD group, followed by the moderate and simple CHD groups, as well as the normal control groups (short stature at 4-6 years of age: 10.7%vs. 8.9% vs. 5.9% vs. 2.4%, p<0.001). Growth curves illustrated that patients with complex CHD experience persistent height and weight impairments throughout the preschool period. The beta estimate (standard error) of height was-0.432 standard deviation score (SDS) (0.041) for the complex CHD group, -0.343 SDS (0.028) for the moderate CHD group, and-0.200 SDS (0.005) for the simple CHD group. Conclusions: Children with CHD showed poor growth outcomes throughout the preschool period. We highlight the importance of longitudinal growth surveillance for high-risk children with CHD during this period to mitigate the development of health issues.