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Catch-up growth in term and preterm infants after surgical closure of ventricular septal defect in the first year of life

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Abstract

Growth impairment in infants with unrestrictive ventricular septal defects (VSD) is common, and normalisation of growth has been reported after surgical correction. Literature is inconsistent about growth velocity after surgery in term and preterm infants. We aimed to establish the pattern of catch-up growth in term and preterm infants submitted to VSD surgical correction before 1 year of age. Fifty-two infants (41 term, 11 preterm) were studied. Anthropometric data at birth, surgery and 3, 6, 12 and 24 months after surgery were collected retrospectively. Statistic analyses were performed in SPSS® version 21. At the time of surgery, growth was severely impaired in term and preterm infants. Term infants underwent a period of fast growth within the first 6 months after surgery, achieving posteriorly a normal growth pattern, as both weight and height were not significantly different from the reference population at 24 months after surgery. Preterms caught-up later than term infants but with a significant weight gain within 3 months after surgery.

Conclusion: Early surgical repair of VSD leads to a significant acceleration of growth within 3 to 6 months after surgery, for both groups.

What is Known:

• Growth impairment in infants with unrestrictive ventricular septal defects is well documented in literature.

• Surgical correction in the first months of life is the current option for most ventricular septal defects, leading to a more favourable growth pattern.

• Rapid growth during infancy may be associated with the development of insulin resistance, metabolic syndrome, obesity and cardiovascular disease later in life.

What is New:

• Literature is inconsistent about catch-up growth velocities after ventricular correction for term infants.

• Preterm infants have never been enrolled in previous studies that aimed to establish a pattern of growth after surgery.

• This group of children, who underwent a rapid post-surgery catch-up growth that follows a period of failure to thrive, may be at a higher risk of insulin resistance, metabolic syndrome, obesity and cardiovascular disease.

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Abbreviations

VSD:

Ventricular septal defect

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The individual contributions to the paper

Luísa Correia Martins is responsible for bibliographic research, study design, data collection, interpretation of results and paper writing. Rita Lourenço is responsible for bibliographic research, data collection and paper revision. Susana Cordeiro is responsible for conversion of weight and height data in Z-scores and paper revision. Nuno Carvalho is responsible for patient care and paper revision. Ines Mendes is responsible for paper revision. Marisa Loureiro and Miguel Patrício are responsible for application of study design in statistical analysis, statistical analysis, interpretation of results and paper revision. Rui Anjos is responsible for formulating the idea of the study, study design, interpretation of results, paper writing and paper revision

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Authors and Affiliations

  1. Pediatric Department, Hospital do Divino Espírito Santo de Ponta Delgada, EPE, Avenida D. Manuel I, Ponta Delgada, 9500-370, São Miguel, Azores, Portugal

    Luísa Correia Martins & Rita Lourenço

  2. Pediatric Cardiology Department, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, EPE, Avenida Prof. Reinaldo dos Santos, Carnaxide, 2790-134, Lisbon, Portugal

    Susana Cordeiro, Nuno Carvalho, Inês Mendes & Rui Anjos

  3. Laboratory of Biostatistics and Medical Informatics, IBILI-Faculty of Medicine of University of Coimbra, Azinhaga de Santa Comba-Celas, 3000-548, Coimbra, Portugal

    Marisa Loureiro & Miguel Patrício

Authors
  1. Luísa Correia Martins
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  2. Rita Lourenço
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  3. Susana Cordeiro
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  4. Nuno Carvalho
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  5. Inês Mendes
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  6. Marisa Loureiro
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  7. Miguel Patrício
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  8. Rui Anjos
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Corresponding author

Correspondence to Luísa Correia Martins.

Ethics declarations

This study was not funded by any entity. All authors declare that they have no conflict of interest. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Communicated by Jaan Toelen

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Correia Martins, L., Lourenço, R., Cordeiro, S. et al. Catch-up growth in term and preterm infants after surgical closure of ventricular septal defect in the first year of life. Eur J Pediatr 175, 573–579 (2016). https://doi.org/10.1007/s00431-015-2676-4

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  • DOI: https://doi.org/10.1007/s00431-015-2676-4

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