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

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• 作者：Thomas A. Miller ; DO¹ ; ^{thomas.a.miller@hsc.utah.edu" class="auth_mail" title="E-mail the corresponding author} ; Victor Zak ; PhD² ; Peter Shrader ; MA² ; Chitra Ravishankar ; MD³ ; Victoria L. Pemberton ; RNC ; MS⁴ ; Jane W. Newburger ; MD⁵ ; Amanda J. Shillingford ; MD⁶ ; Nicholas Dagincourt ; MS² ; James F. Cnota ; MD⁷ ; Linda M. Lambert ; MSN⁸ ; Renee Sananes ; PhD⁹ ; Marc E. Richmond ; MD ; MS¹⁰ ; Daphne T. Hsu ; MD¹¹ ; Stephen G. Miller ; MD¹² ; Sinai C. Zyblewski ; MD¹³ ; Richard V. Williams ; MD¹ ; on behalf of the Pediatric Heart Network Investigators^&lowast ; Thomas A. Miller ; DO ; Victor Zak ; PhD ; Peter Shrader ; MA ; Chitra Ravishankar ; MD ; Victoria L. Pemberton ; RNC ; MS ; Jane W. Newburger ; MD ; Amanda J. Shillingford ; MD ; Nicholas Dagincourt ; MS ; James F. Cnota ; MD ; Linda M. Lambert ; MSN ; Renee Sananes ; PhD ; Marc E. Richmond ; MD ; MS ; Daphne T. Hsu ; MD ; Stephen G. Miller ; MD ; Sinai C. Zyblewski ; MD ; Richard V. Williams ; MD
• 关键词：BSID-II ; Bayley Scales of Infant Development-II ; HCAZ ; Head circumference-for-age z-score ; HLHS ; Hypoplastic left heart syndrome ; ISV ; Infant Single Ventricle ; IUGR ; Intrauterine growth restriction ; LAZ ; Length-for-age z-score ; MDI ; Mental Developmental Index ; PDI ; Psychomotor Developmental Index ; SCPC ; Superior cavopulmonary connection ; SV ; Single ventricle ; WAZ ; Weight-for-age z-score ; WLZ ; Weight-for-length z-score
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：168
• 期：Complete
• 页码：220-225.e1
• 全文大小：386 K

文摘

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

absSec_2">Study design

abspara0015">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.

absSec_3">Results

abspara0020">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.

absSec_4">Conclusion

abspara0025">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.

absSec_5">Trial registration

abspara0030">an id="intref0015" class="interref" data-locatorType="url" data-locatorKey="http://Clinicaltrials.gov">Clinicaltrials.gova>an>: an id="intref0020" class="interref" data-locatorType="ctgov" data-locatorKey="NCT00113087">NCT00113087a>an>.