Delay in Bone Age in Children with Cyanotic Congenital Heart Disease

Of 110 children with congenital heart disease evaluated for bone age, 61 were cyanotic and 49 had normal systemic saturation. Cyanotic children had a much higher incidence (22∕61) of retarded bone age than did the acyanotic group (3∕49) (p < 0.001). The correlation between resting systemic oxygen saturation and bone age retardation was significant (r = +.733) and an oxygen saturation of 75% at rest appeared critical. All laboratory values were within normal limits except for the finding of polycythemia. Hypoxemia appears to be a significant factor in bone age and growth retardation when resting systemic oxygen saturation is 75% or less. It is postulated that this retardation in bone age reflects a local cellular response to hypoxemia.