Some Kids With Heart Defects May Experience Abnormal Growth Regulation

Children who are born with complex heart defects like congenital heart disease can often have poor growth. A new study from a pediatric cardiologist and her team at The Children’s Hospital of Philadelphia suggests that that this poor growth may stem from factors beyond deficient nutrition, and may include abnormalities in overall growth regulation.

Meryl S. Cohen, MD, of the Cardiac Center at Children’s Hospital, led a study that looked at the medical records of more than 850 children with congenital heart disease and compared those to more than 7,600 control subjects.

Researchers had previously known that children with congenital heart disease are at an increased risk for poor growth, but this analysis provides a fuller picture of the problem. Investigating the patterns of poor growth in children with the disease gave Dr. Cohen and the other investigators a starting point in guiding them toward more effective treatments.

While looking at the children’s growth patterns, Dr. Cohen and her team noticed that children with congenital heart disease had significant deficits in weight, length and head circumference, compared to others without the disease. The researchers also noted that when caloric intake is insufficient the weight of an infant in the general population is usually affected first, followed later by length and head circumference.

In addition, those children who required surgery for their condition much more likely to be below the 3rd percentile in weight, length and head circumference during early infancy, and their growth by age 3 did not catch up with that of their healthy peers, according to the study.

“The fact that all three parameters changed simultaneously rather than sequentially supports the idea that impaired growth in children with heart disease is affected at least in part by factors unrelated to nutrition,” said Dr. Cohen.

Further studies should investigate the possible roles of growth hormones and other physiologic factors that affect growth regulation in children with CHD, Dr. Cohen added.

More information about the study is available on the CHOP Research Institute’s website.