Patterns of Weight Change in Infants with Congenital Heart Disease following Neonatal Surgery: Potential Predictors of Growth Failure

Abstract Patterns of Weight Change in Infants with Congenital Heart Disease Following Neonatal Surgery: Potential predictors of growth failure Sharon Y Irving DISSERTATION SUPERVISOR: BARBARA MEDOFF-COOPER, RN, PhD Congenital heart disease (CHD) is reported to have an incidence of 9 to 14 per 1000 live births with a prevalence estimated between 650,000 and 1.3 million persons in the United States (US). It is a structural malformation(s) of one or more heart chamber(s) and/or deformity of one or more of the major intrathoracic blood vessel(s) and the ensuing malady occurring during embryonic development. Up to one-third of infants with CHD, require surgical intervention. Improved surgical technique over the last several decades has seen an increased survival of neonates with CHD. Concomitantly there has been an emergence of co-morbidities. Growth failure is a common co-morbidity following neonatal surgery for CHD. More than 30% of these infants fall below the third percentile for weight early in their lives. Postsurgical physiology, disease severity, feeding dysfunction, and a hypermetabolic state may all contribute to growth failure, which has been associated with deficits in cognitive development, intellectual ability and neurodevelopment, effecting maturation and school performance. Early recognition and intervention of growth failure can improve health outcomes. The objective of this work is to identify patterns of growth and growth failure in infants with CHD and explore potential predictors that may be modifiable to mitigate growth failure and prevent the associated untoward consequences. Degree Type Dissertation Degree Name Doctor of Philosophy (PhD) Graduate Group Nursing First Advisor Barbara Medoff-Cooper, RN, PhD Second Advisor Martha A.Q. Curley, RN, PhD This dissertation is available at ScholarlyCommons: http://repository.upenn.edu/edissertations/443 Third Advisor Virginia A. Stallings, MD