Predictors of poor weight gain in infants with a single ventricle

Objective: To assess growth from the time of neonatal discharge to the time of performance of the bidirectional Glenn (BDG) procedure in infants with a single ventricle and determine predictors of poor growth. Study design: We performed a retrospective case series of infants who underwent the BDG procedure at our institution between January 2001 and December 2007 (n = 102). Anthropometric and clinical data were recorded during neonatal hospitalization and before BDG. Outcome variables included weight-for-age z-score (WAZ) at the time of BDG and average daily weight gain between neonatal discharge and BDG. Results: Median age at the time of BDG was 5.1 months (range, 2.4-10 months), and median WAZ was -0.4 (range, -2.6 to 3.2) at neonatal admission and -1.3 (range, -3.9 to 0.6) at the time of BDG. Non-Caucasian infants (P = .03) and those with lower WAZ at neonatal discharge (P <.0001) had a lower WAZ at BDG. Being formula-fed at neonatal discharge (P = .04), and having higher mean pulmonary arterial pressure (P = .04) and systemic oxygen saturation (P = .006) were associated with lower average daily weight gain between neonatal discharge and BDG. Conclusions: Infants with a single ventricle have poor weight gain between neonatal discharge and BDG. Non-Caucasian infants and those with evidence of increased pulmonary blood flow are at particular risk for growth failure.