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 were compared between the 2 groups using mixed-effects linear regression. RESULT: Between September 2018 and November 2019, 801 patients had data collected. The z-score trend decreased (e.g., ΔWAZ: 1.29±1.44) and then increased (e.g., ΔWAZ: 1.06±1.13), and all z-scores were below 0 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 = .03) (WLZ: β = -0.93, 95% CI, -1.67 to -0.19; P = .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 = .02) (WLZ: interaction β = -0.36; 95% CI, -0.60 to -0.12; P = .004) (LAZ: interaction β = -0.29; 95% CI, -0.56 to -0.02; P = .04). 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.