Highlights
- •We identified 4 classes of WAZ-GT in infants with cCHD.
- •The same classes were found in one and two ventricle cCHD.
- •Half of infants fell into poor WAZ-GT classes.
- •Interventions can target the predictors of poor WAZ-GT.
Abstract
Purpose
We aimed to describe the weight-for-age Z-score growth trajectory (WAZ-GT) of infants with complex congenital heart disease
(cCHD) after neonatal cardiac surgery in the first 4 months of life and assess potential
risk factors.
Methods
We utilized data from a previously reported trial of the REACH telehealth home monitoring
(NCT01941667) program which evaluated 178 infants with cCHD from 2012 to 2017. Over
the first 4 months of life, weekly infant weights were converted to WAZ. WAZ-GT classes
were identified using latent class growth modeling. Multinomial logistic regression
models were used to examine the associations between potential risk factors and WAZ-GT
classes.
Results
Four distinct classes of WAZ-GT were identified: maintaining WAZ > 0, 14%; stable
around WAZ = 0, 35%; partially recovered, 28%; never recovered, 23%. Compared with
reference group “stable around WAZ=0,” we identified clinical and sociodemographic
determinants of class membership for the three remaining groups. “Maintaining WAZ
> 0” had greater odds of having biventricular physiology, borderline appetite, and
a parent with at least a college education. “Partially recovered” had greater odds
of hospital length of stay>14 days and being a single child in the household. “Never
recovered” had greater odds hospital length of stay >14 and > 30 days, tube feeding
at discharge, and low appetite.
Conclusions
This study described distinct classes of WAZ-GT for infants with cCHD early in infancy
and identified associated determinants.
Practice implications
Findings from this study can be used in the identification of infants at risk of poor
WAZ-GT and in the design of interventions to target growth in this vulnerable patient
population.
Keywords
Abbreviations:
cCHD (complex congenital heart disease), LOS (length of stay), WAZ (weight-for-age Z-score), WAZ-GT (weight-for-age Z-score growth trajectory)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 20, 2022
Accepted:
May 5,
2022
Received in revised form:
May 5,
2022
Received:
January 18,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
