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Medicine and Healthcare

No Catch-up Growth in Children with Congenital Heart Disease

Close monitoring required

Scientific name of the study

Somatic Development in Children with Congenital Heart Defects

A comprehensive study by the Competence Network for Congenital Heart Defects confirms it: Children with heart defects are smaller. At the same time, they are at increased risk of long-term impairment in their mental, physical, and psychomotor development.

It is obvious that a congenital heart defect affects a child's physical development. But how exactly? What is the role of heart surgery? And what other factors should be considered? To assess this, doctors need information on the development of the patient's head circumference, body weight, and body length. Researchers from the Competence Network for Congenital Heart Defects have identified such indicators in one of the largest comparative clinical studies ever conducted in this field.

KiGGS and Berlin Longitudinal Study Provide Comparative Data

The research team led by Martin Poryo from the Department of Pediatric Cardiology at Saarland University compared the long-term development of 2,818 patients included in the Competence Network's PAN study with the normal values of children and adolescents determined in two other studies.

The researchers used the KiGGS study by the Robert Koch Institute on the health of children and adolescents in Germany and the Berlin Longitudinal Study from 2016. The growth study on the age-dependent physical development of children between the ages of 0 and 6 was conducted as part of the German Language Development Study research project with the support of the German Center for Growth, Development and Health Promotion in Childhood and Adolescence (DeuZ-W.E.G.).

Below the Standard Values

The comparison with standard values from both studies showed that the head circumference, body weight, and body length of children with moderate to severe congenital heart defects are well below standard values.

The researchers also found that necessary heart surgery affects physical development. "Children who had to undergo heart surgery showed significantly more developmental problems than those who did not," says Martin Poryo. At the same time, the researchers found no evidence that the values returned to the normal range in the course of physical development. "Such catch-up growth could not be observed," says the pediatric cardiologist.

  • Background

    Research Base PAN Study

    Congenital Heart Disease in Germany

    The Competence Network used this image to recruit study participants for the PAN study. Data from around 20,000 patients were collected nationwide.

    The PAN study of the Competence Network for Congenital Heart Defects on the prevalence of the underlying disease, conducted between 2006 and 2009, provided the representative data basis for the study published in January 2018 under the title "Somatic Development in Children with Congenital Heart Defects". The PAN study (Prevalence of Congenital Heart Defects in Newborns in Germany) was the first to prospectively determine the frequency of congenital heart defects in newborns throughout Germany.

    Over a four-year period, researchers collected and analyzed comprehensive data on the incidence of cardiac malformations in newborns from several consecutive birth cohorts.

    The PAN study involved pediatric cardiology clinics, children's hospitals, and pediatric cardiology practices from all over Germany.

    The results provided important information on fundamental deficits in the medical care of children, adolescents, and adults with congenital heart defects.

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Health risk microcephaly

The Competence Network study on the physical development of children with congenital heart defects also found that patients are more prone to microcephaly. Children who have undergone heart surgery are more likely to be affected. Scientists say the findings emphasize the importance of early diagnosis and timely correction of heart defects.

Since an abnormally small head circumference can be associated with long-term impaired neurological and psychomotor development, children with congenital heart defects should be continuously and closely monitored for neurological abnormalities.

In addition, the researchers strongly recommend targeted support for the physical development in children with congenital heart defects. "Language, motor skills, coordination, and responsiveness develop differently in children with heart defects. Specialized preventive care is therefore strongly recommended, even beyond the scope of U1 to U9 examinations.

Our findings also point to the urgent need for individual learning and exercise programs that support each child according to his or her specific abilities," concludes Martin Poryo.

  • Scientific Details of the Study

    Learn more about the study design, material and methods, as well as the background of the study:

    Publications

    • 1/2018

      Somatic Development in Children with Congenital Heart Defects.

      Poryo M, Paes LA, Pickardt T, Bauer UMM, Meyer S, Wagenpfeil S, Abdul-Khaliq H

      The Journal of pediatrics 192, 136-143.e4, (2018). Show this publication on PubMed.

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