Factors Associated with Growth in a Cohort of Children with Complex Biventricular Congenital Heart Disease

Christopher Teng, Di Shu, Jennifer A. Faerber, Jacob Goldenring, Arene Butto, Vicky Tam, Robert Olsen, Andrew C. Glatz, Meryl S. Cohen

Research output: Contribution to journalArticlepeer-review


Objectives: To evaluate patterns and determinants of longitudinal growth among children requiring complex biventricular repair for congenital heart disease, as well as to assess for associations of growth with early feeding modality, comorbidities, postoperative complications, and socioeconomic characteristics. Study design: A single-institution retrospective cohort study was performed in children born February 1999 to March 2009 with complex congenital heart disease who underwent biventricular repair before age 4 years, defined by Risk Adjustment in Congenital Heart Surgery-1 category 3-5. Clinical characteristics, height, weight, and body mass index (BMI) from ages 2-12 years were collected by chart review. Neighborhood-level socioeconomic data were identified using a geographic information system approach. The adjusted association of covariates with growth outcomes was estimated using multivariable linear regression models using generalized estimating equations. Results: Compared with population growth curves, the cohort (n = 150) trended toward early decrease in age-adjusted weight and height. Early tube feeding was significantly associated with decreased BMI before adolescence (−0.539; 95% CI −1.02, −0.054; P = .029). In addition, other clinical and perioperative characteristics had significant associations with growth, including low birth weight, preoperative tube feeds, need for multiple bypass runs, and diagnosis of feeding disorder. Conclusions: Early childhood growth in children with complex biventricular repair may be impaired. Early tube feeding was associated with decreased BMI over the course of early childhood, which may indicate a need for continued close nutrition follow-up and support even beyond the duration of tube feeds.

Original languageEnglish
Article number113901
JournalJournal of Pediatrics
StatePublished - Apr 2024


  • enteral tube feeding
  • nutrition
  • pediatric cardiology
  • social determinants of health


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