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J Pediatr. 2016 Jan;168:220-5.e1. doi: 10.1016/j.jpeds.2015.09.041. Epub 2015 Oct 17.

Growth Asymmetry, Head Circumference, and Neurodevelopmental Outcomes in Infants with Single Ventricles.

Author information

1
Department of Pediatrics, University of Utah, Salt Lake City, UT. Electronic address: thomas.a.miller@hsc.utah.edu.
2
New England Research Institute, Watertown, MA.
3
Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA.
4
National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
5
Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA.
6
Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee, WI.
7
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
8
Department of Surgery, University of Utah, Salt Lake City, UT.
9
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
10
Department of Pediatrics, Columbia University Medical Center, New York, NY.
11
Department of Pediatrics, Children's Hospital at Montefiore/Albert Einstein College of Medicine, New York, NY.
12
Department of Pediatrics, Duke University Medical Center, Durham, NC.
13
Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
14
Department of Pediatrics, University of Utah, Salt Lake City, UT.

Abstract

OBJECTIVE:

To assess the variability in asymmetric growth and its association with neurodevelopment in infants with single ventricle (SV).

STUDY DESIGN:

We analyzed weight-for-age z-score minus head circumference-for-age z-score (HCAZ), relative head growth (cm/kg), along with individual growth variables in subjects prospectively enrolled in the Infant Single Ventricle Trial. Associations between growth indices and scores on the Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI) of the Bayley Scales of Infant Development-II (BSID-II) at 14 months were assessed.

RESULTS:

Of the 230 subjects enrolled in the Infant Single Ventricle trial, complete growth data and BSID-II scores were available in 168 (73%). Across the cohort, indices of asymmetric growth varied widely at enrollment and before superior cavopulmonary connection (SCPC) surgery. BSID-II scores were not associated with these asymmetry indices. In bivariate analyses, greater pre-SCPC HCAZ correlated with higher MDI (r = 0.21; P = .006) and PDI (r = 0.38; P < .001) and a greater HCAZ increase from enrollment to pre-SCPC with higher PDI (r = 0.15; P = .049). In multivariable modeling, pre-SCPC HCAZ was an independent predictor of PDI (P = .03), but not MDI.

CONCLUSION:

In infants with SV, growth asymmetry was not associated with neurodevelopment at 14 months, but pre-SCPC HCAZ was associated with PDI. Asymmetric growth, important in other high-risk infants, is not a brain-sparing adaptation in infants with SV.

TRIAL REGISTRATION:

Clinicaltrials.gov: NCT00113087.

PMID:
26490132
PMCID:
PMC4698012
DOI:
10.1016/j.jpeds.2015.09.041
[Indexed for MEDLINE]
Free PMC Article

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