Short-midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgery
Abstract Objective To assess the factors associated with early occurrence of extrauterine growth restriction (EUGR) in preterm infants with critical congenital heart disease (CCHD) and their short-midterm outcomes. Methods This was a single-center retrospective study including a cohort of all premat...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12887-025-05892-2 |
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| author | Yuan Li Zhi-Ye Yao Liang Chen Jin Zhong Man-Li Zheng Xi-Meng Wang Yan-Ling Chen Xin Sun Yu-Mei Liu Shao-Ru He |
| author_facet | Yuan Li Zhi-Ye Yao Liang Chen Jin Zhong Man-Li Zheng Xi-Meng Wang Yan-Ling Chen Xin Sun Yu-Mei Liu Shao-Ru He |
| author_sort | Yuan Li |
| collection | DOAJ |
| description | Abstract Objective To assess the factors associated with early occurrence of extrauterine growth restriction (EUGR) in preterm infants with critical congenital heart disease (CCHD) and their short-midterm outcomes. Methods This was a single-center retrospective study including a cohort of all premature infants (< 37weeks) undergoing surgery for CCHD at Guangdong Provincial People’s Hospital from 2011 to 2022. According to the diagnostic and exclusion criteria, the subjects were divided into malnourished and un-malnourished groups. The clinical characteristics and nutrition outcomes of patients were collected and compared. Results Among the entire cohort of 118 preterm neonates with critical congenital heart disease (CCHD), 46 (39.0%) were malnourished before the operation, and 72 (61.0%) were non-malnourished. The BWZ (birth weight Z-score) [OR = 0.041, (0.012, 0.143), P < 0.001] of preoperative extrauterine growth restriction (EUGR) was lower. In addition, the preoperational non-EUGR group had earlier operation age [OR = 1.076, (1.032, 1.122), P = 0.001] and less liquid volume [OR = 1.032, (1.000, 1.066), P = 0.050]. After surgery, the preoperative EUGR group fasted [(5.28 ± 0.933) vs. (3.92 ± 0.411) days, P = 0.021] and hospitalized [(43.10 ± 3.683) vs. (31.89 ± 2.301) days, P = 0.007] for a longer time. The WAZ (weight of age Z-score) of the preoperative EUGR group was lower at discharge [(-3.84 ± 0.166) vs. (-1.75 ± 0.138), P < 0.001] and more of them were still malnourished [13(38.2%) vs. 4(5.6%), P = 0.006] till 2-year follow-up. We found 14.41% mortality total, of which 11.86% was in hospital. Conclusion Preoperative low weight-for-age, influenced by both congenital (e.g., SGA) and postnatal factors, predicts prolonged recovery and persistent growth deficits in preterm infants with CCHD. Comprehensive nutritional strategies must address both intrauterine and extrauterine contributors to growth failure. |
| format | Article |
| id | doaj-art-9e49e6d9301e45aab472a7f35da291b0 |
| institution | DOAJ |
| issn | 1471-2431 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Pediatrics |
| spelling | doaj-art-9e49e6d9301e45aab472a7f35da291b02025-08-20T03:06:05ZengBMCBMC Pediatrics1471-24312025-07-012511910.1186/s12887-025-05892-2Short-midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgeryYuan Li0Zhi-Ye Yao1Liang Chen2Jin Zhong3Man-Li Zheng4Xi-Meng Wang5Yan-Ling Chen6Xin Sun7Yu-Mei Liu8Shao-Ru He9Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of NICU, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of NICU, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of NICU, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of NICU, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityPrevention and Treatment Research Office for Cardiovascular Diseases and Epidemiological Research Office, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of NICU, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of NICU, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of NICU, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesAbstract Objective To assess the factors associated with early occurrence of extrauterine growth restriction (EUGR) in preterm infants with critical congenital heart disease (CCHD) and their short-midterm outcomes. Methods This was a single-center retrospective study including a cohort of all premature infants (< 37weeks) undergoing surgery for CCHD at Guangdong Provincial People’s Hospital from 2011 to 2022. According to the diagnostic and exclusion criteria, the subjects were divided into malnourished and un-malnourished groups. The clinical characteristics and nutrition outcomes of patients were collected and compared. Results Among the entire cohort of 118 preterm neonates with critical congenital heart disease (CCHD), 46 (39.0%) were malnourished before the operation, and 72 (61.0%) were non-malnourished. The BWZ (birth weight Z-score) [OR = 0.041, (0.012, 0.143), P < 0.001] of preoperative extrauterine growth restriction (EUGR) was lower. In addition, the preoperational non-EUGR group had earlier operation age [OR = 1.076, (1.032, 1.122), P = 0.001] and less liquid volume [OR = 1.032, (1.000, 1.066), P = 0.050]. After surgery, the preoperative EUGR group fasted [(5.28 ± 0.933) vs. (3.92 ± 0.411) days, P = 0.021] and hospitalized [(43.10 ± 3.683) vs. (31.89 ± 2.301) days, P = 0.007] for a longer time. The WAZ (weight of age Z-score) of the preoperative EUGR group was lower at discharge [(-3.84 ± 0.166) vs. (-1.75 ± 0.138), P < 0.001] and more of them were still malnourished [13(38.2%) vs. 4(5.6%), P = 0.006] till 2-year follow-up. We found 14.41% mortality total, of which 11.86% was in hospital. Conclusion Preoperative low weight-for-age, influenced by both congenital (e.g., SGA) and postnatal factors, predicts prolonged recovery and persistent growth deficits in preterm infants with CCHD. Comprehensive nutritional strategies must address both intrauterine and extrauterine contributors to growth failure.https://doi.org/10.1186/s12887-025-05892-2PretermCritical congenital heart diseaseNutritionOutcomesSurgery |
| spellingShingle | Yuan Li Zhi-Ye Yao Liang Chen Jin Zhong Man-Li Zheng Xi-Meng Wang Yan-Ling Chen Xin Sun Yu-Mei Liu Shao-Ru He Short-midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgery BMC Pediatrics Preterm Critical congenital heart disease Nutrition Outcomes Surgery |
| title | Short-midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgery |
| title_full | Short-midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgery |
| title_fullStr | Short-midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgery |
| title_full_unstemmed | Short-midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgery |
| title_short | Short-midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgery |
| title_sort | short midterm outcomes of preoperative extrauterine growth restriction in premature infants with critical congenital heart disease after surgery |
| topic | Preterm Critical congenital heart disease Nutrition Outcomes Surgery |
| url | https://doi.org/10.1186/s12887-025-05892-2 |
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