A Study On Neurodevelopmental And Nutritional Status In Children With Teralogy Of Fallot

Objective:1. To evaluate the status of neurodevelopment and nutrition outcome of infants with Tetralogy of Fallot(TOF) at our department.2. To identify the high risk factors for neurodevelopment impairments and malnutrition of them. At last.3. To explore the impact of total correction operation on nutritional status of children with teralogy of fallot.Methods:1. The first part of the study:Neurodevelopment outcome of children with TOF were all assessed using Bayley Scales of Infant Development test(BSID). They were devided into two different groups. Compare the risk factors we supposed between the two groups, put the significant factors into Single factor linear regression analysis.Then potential high risk factors were analyzed with multiple linear regression.2. The second part of the study:Information including demographic data and cardiac problems was obtained from patient records and parental interview. Nutritional status was assessed by Z-score method,patients were divided in to two groups.The groups were compared, and the significant factors were put into Single factor logistic regression analysis.Then potential risk factors were analyzed with multiple logistic regression.3. The third part of the study:Information including demographic data,cardiac problems was obtained after operation forlmonth,3month,6month and lyear, respectively. Nutritional status were compared between pre and post surgry.Result:1. The first part of the study:There were83infants with a mean MDI(mental development idex) of98.07±16.83and a mean PDI(psychomotor development idex) of26.62±11.31.For MDI,excellent, upper-middle, middle, lower-middle, critical and delay ocurredd in3case (3.6%),14case (16%),33case (39.8%),17case (20.5%),1lease (13.3%),5case (6.0%); for PDI,4case(4.8%),37case (44.6%),20case (24.1%),16case (19.3%),6case (7.2%) respectively.Multiple linear regression showed MaGoon index,LVEDI(Left ventricular end-diastolic capacity index) and age pre-surgry were related to MDI scores,and low MaGoon index,LVEDI(Left ventricular end-diastolic capacity index) may contributte to the lower PDI scores.2. The second part of the study:142TOF infants were admitted in this study. The nutritional status of the patients before surgery was defined as normal57%, malnutrition47%and over-nutrition2%. Malnutrition included underweight25.4%, wasting21.8%and stunting14.8%.The results revaled that low brith weight/premature birth are related to under weight, low brith weight/premature birth and caynosis may contribute to wasting, premature birth/caynosis and McGoon index <1.2are associated with stunning.3. The third part of the study:One year after operation,the means of ZWA (0.64±0.86vs-1.12±1.23),ZWH (0.56±1.02vs-1.03±1.05) andZHA (0.51±0.18vs-1.06±1.75) were significantly increased,and the prevalence of underweight,wasting and stunting were decreased to11.5%,8.7%and10.1%respectively.Conclusion:1. The infants with TOF are a group of neurodevelopment disablement.it is closely related to the MaGoon index,LVEDI,and the age at surgery. Malnutrition is common in pediatric patients with TOF.2. Low brith weight/premature birth/matern BMI<18.5and LEVDI<20ml/m2are related to malnutrition.3. total correction sugery have a significanat postive effect on tnutritional status.