Factors affecting growth in infants with single ventricle physiology: A report from the pediatric heart network infant single ventricle trial

Richard V. Williams, Victor Zak, Chitra Ravishankar, Karen Altmann, Jeffrey Anderson, Andrew M. Atz, Carolyn Dunbar-Masterson, Nancy Ghanayem, Linda Lambert, Karen Lurito, Barbara Medoff-Cooper, Renee Margossian, Victoria L. Pemberton, Jennifer Russell, Mario Stylianou, Daphne Hsu

Research output: Contribution to journalArticle

58 Scopus citations

Abstract

Objectives: To describe growth patterns in infants with single ventricle physiology and determine factors influencing growth. Study design: Data from 230 subjects enrolled in the Pediatric Heart Network Infant Single Ventricle Enalapril Trial were used to assess factors influencing change in weight-for-age z-score (z) from study enrollment (0.7 ± 0.4 months) to pre-superior cavopulmonary connection (SCPC; 5.1 ± 1.8 months, period 1) and pre-SCPC to final study visit (14.1 ± 0.9 months, period 2). Predictor variables included patient characteristics, feeding regimen, clinical center, and medical factors during neonatal (period 1) and SCPC hospitalizations (period 2). Univariate regression analysis was performed, followed by backward stepwise regression and bootstrapping reliability to inform a final multivariable model. Results: Weights were available for 197 of 230 subjects for period 1 and 173 of 197 subjects for period 2. For period 1, greater gestational age, younger age at study enrollment, tube feeding at neonatal hospitalization discharge, and clinical center were associated with a greater negative z (poorer growth) in multivariable modeling (adjusted R2 = 0.39, P <.001). For period 2, younger age at SCPC and greater daily caloric intake were associated with greater positive z (better growth; R2 = 0.10, P =.002). Conclusions: Aggressive nutritional support and earlier SCPC are modifiable factors associated with a favorable change in weight-for-age z-score.

Original languageEnglish (US)
Pages (from-to)1017-1022.e2
JournalJournal of Pediatrics
Volume159
Issue number6
DOIs
StatePublished - Dec 2011
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Williams, R. V., Zak, V., Ravishankar, C., Altmann, K., Anderson, J., Atz, A. M., Dunbar-Masterson, C., Ghanayem, N., Lambert, L., Lurito, K., Medoff-Cooper, B., Margossian, R., Pemberton, V. L., Russell, J., Stylianou, M., & Hsu, D. (2011). Factors affecting growth in infants with single ventricle physiology: A report from the pediatric heart network infant single ventricle trial. Journal of Pediatrics, 159(6), 1017-1022.e2. https://doi.org/10.1016/j.jpeds.2011.05.051