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Growth Trajectory in Children with Trisomy 21 with and without Atrioventricular Septal Defect. Congenit Heart Dis 2016 Jul;11(4):348-53

Date

05/31/2016

Pubmed ID

27237622

DOI

10.1111/chd.12378

Scopus ID

2-s2.0-84981742780 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

OBJECTIVE: Trisomy 21 is associated with poor weight gain and atrioventricular septal defects. The impact of atrioventricular septal defects on weight gain in the setting of Trisomy 21 has not previously been described in the recent era. This study aimed to determine if such an association is present.

DESIGN: Patients with Trisomy 21 with and without atrioventricular septal defects were identified. Clinical, surgical, and postoperative data were collected were for these patients and then compared between patients. Specifically, weight for age z-scores were compared at various time points in a univariate and multivariate fashion. Effect of timing of surgery in those with an atrioventricular septal defect was also studied.

RESULTS: A total of 86 patients were identified, 42 with an atrioventricular septal defect. There was a difference in weight for age z-scores between patients with and without atrioventricular septal defects only at 2 months (P value .038) and 6 months (P value .003) of age. This persisted after multivariate regression which demonstrated atrioventricular septal defects as an independent risk factor. There was no difference noted in weight at 2 years of age in patients undergoing atrioventricular septal defect repair before and 150 days of life.

CONCLUSION: There was a statistically significant, but not clinically relevant, difference in weight between the patients with Trisomy 21 with and without atrioventricular septal defects in our cohort. Those with atrioventricular septal defects required more nutritional intervention, such as gastrostomy tube placement. Timing of repair did not alter outcomes at midterm follow-up.

Author List

Mackman CA, Loomba RS, Slicker J, Bartz PJ

Author

Peter J. Bartz MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Age Factors
Cardiac Surgical Procedures
Chi-Square Distribution
Child Development
Child, Preschool
Down Syndrome
Electronic Health Records
Female
Heart Septal Defects
Humans
Infant
Infant Nutritional Physiological Phenomena
Infant, Newborn
Linear Models
Logistic Models
Male
Multivariate Analysis
Nutritional Status
Nutritional Support
Retrospective Studies
Time Factors
Weight Gain