{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:10:36Z","timestamp":1790482236047,"version":"4.1.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Background and Objectives:<\/jats:bold> Congenital heart defects (CHD) and growth restriction at birth are two major causes of childhood and adult morbidity and mortality. The aim of this study was to assess the overall risk of growth restriction at birth, as measured by its imperfect proxy small (&amp;lt; 10th percentile) for gestational age (SGA), for newborns with CHD.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Using data from a population-based cohort of children born with CHD, we assessed the risk of growth restriction at birth using SGA and severe SGA (3rd percentile). To compare the odds of SGA and severe SGA across five specific major CHD, we used ordinal logistic regression using isolated, minor (non-operated) ventricular septal defect (VSD) as the control group.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The overall proportion of SGA for \u201cisolated\u201d CHD (i.e., those not associated with other anomalies) was 13% (95% CI, 12\u201315%), which is 30% higher than what would be expected in the general population (i.e., 10%). The risk of severe SGA was 5% (95% CI, 4\u20136%) as compared with the expected 3% in the general population. There were substantial differences in the risk of overall SGA and more so severe SGA across the different CHD. The highest risk of SGA occurred for Tetralogy of Fallot (adjusted OR 2.7, 95% CI, 1.3\u20135.8) and operated VSD (adjusted OR 2.1, 95% CI, 1.1\u20133.8) as compared with the control group of minor (non-operated) VSD.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The overall risks of both SGA and severe SGA were higher in isolated CHD than what would be expected in the general population with substantial differences across the subtypes of CHD. These results may provide a clue for understanding the underlying mechanisms of the relation between alterations in fetal circulation associated with different types of CHD and their effects on fetal growth.<\/jats:p>","DOI":"10.3389\/fped.2021.676994","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T04:48:50Z","timestamp":1622177330000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of Growth Restriction at Birth for Newborns With Congenital Heart Defects: A Population-Based Prospective Cohort Study EPICARD"],"prefix":"10.3389","volume":"9","author":[{"given":"Ali","family":"Ghanchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makan","family":"Rahshenas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damien","family":"Bonnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Derridj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"LeLong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent J.","family":"Salomon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Goffinet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Khoshnood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1055\/s-0030-1254155","article-title":"Prevalence of congenital heart defects in newborns in Germany: results of the first registration year of the PAN Study (July 2006 to June 2007)","volume":"222","author":"Lindinger","year":"2010","journal-title":"Klinische P\u00e4diatrie."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.1016\/j.jacc.2011.08.025","article-title":"Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis","volume":"58","author":"Van Der Linde","year":"2011","journal-title":"J Am College Cardiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"3056","DOI":"10.3390\/ijerph17093056","article-title":"Children born with congenital heart defects and growth restriction at birth: a systematic review and meta-analysis","volume":"17","author":"Ghanchi","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"662","DOI":"10.3109\/14767058.2011.597900","article-title":"Fetal congenital heart disease and intrauterine growth restriction: a retrospective cohort study","volume":"25","author":"Wallenstein","year":"2012","journal-title":"J Maternal-Fetal Neonatal Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1111\/jog.12652","article-title":"Influence of birthweight on perinatal outcome in fetuses with antenatal diagnosis of congenital heart disease","volume":"41","author":"Story","year":"2015","journal-title":"J Obstet Gynaecol Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.1136\/heartjnl-2012-302543","article-title":"Prevalence, timing of diagnosis and mortality of newborns with congenital heart defects: a population-based study","volume":"98","author":"Khoshnood","year":"2012","journal-title":"Heart"},{"key":"B7","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jgyn.2015.08.009","article-title":"Courbes de croissance in utero ajust\u00e9es et non ajust\u00e9es adapt\u00e9es \u00e0 la population fran\u00e7aise. I\u2013M\u00e9thodes de construction","volume":"45","author":"Ego","year":"2016","journal-title":"J Gyn\u00e9col Obst\u00e9trique Biol Reproduction."},{"key":"B8","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1016\/j.jgyn.2013.09.012","article-title":"D\u00e9finitions: petit poids pour l'\u00e2ge gestationnel et retard de croissance intra-ut\u00e9rin [Definitions: small for gestational age and intrauterine growth retardation]","volume":"42","author":"Ego","year":"2013","journal-title":"J Gynecol Obstet Biol Reprod"},{"key":"B9","first-page":"546","article-title":"Ordinal logistic regression in medical research","volume":"31","author":"Bender","year":"1997","journal-title":"J Royal College Phys London."},{"key":"B10","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1783\/147118908784734945","article-title":"Ordinal logistic regression","volume":"34","author":"Warner","year":"2008","journal-title":"BMJ Sexual Reproductive Health."},{"key":"B11","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.jgyn.2015.08.008","article-title":"Customized and non-customized French intrauterine growth curves. II-Comparison with existing curves and benefits of customization","volume":"45","author":"Ego","year":"2015","journal-title":"J Gynecol Obstetrique Biol Reproduction."},{"key":"B12","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.jpeds.2017.12.059","article-title":"Consensus based definition of growth restriction in the newborn","volume":"196","author":"Beune","year":"2018","journal-title":"J Pediatrics."},{"key":"B13","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1161\/CIRCULATIONAHA.115.019089","article-title":"Congenital heart defects and indices of fetal cerebral growth in a nationwide cohort of 924 422 liveborn infants","volume":"133","author":"Matthiesen","year":"2016","journal-title":"Circulation."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1016\/j.placenta.2015.08.003","article-title":"Hypoplastic left heart syndrome is associated with structural and vascular placental abnormalities and leptin dysregulation","volume":"36","author":"Jones","year":"2015","journal-title":"Placenta."},{"key":"B15","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.diff.2012.04.004","article-title":"NOing the heart: role of nitric oxide synthase-3 in heart development","volume":"84","author":"Liu","year":"2012","journal-title":"Differentiation."},{"key":"B16","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/S0143-4004(96)80009-9","article-title":"Nitric oxide concentrations are increased in the feto-placental circulation in intrauterine growth restriction","volume":"17","author":"Lyall","year":"1996","journal-title":"Placenta."},{"key":"B17","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1161\/HYPERTENSIONAHA.112.201996","article-title":"Endothelial NO synthase augments fetoplacental blood flow, placental vascularization, and fetal growth in mice","volume":"61","author":"Kulandavelu","year":"2013","journal-title":"Hypertension."},{"key":"B18","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1046\/j.1469-0705.1995.05040247.x","article-title":"Ventricular ejection force in growth-retarded fetuses","volume":"5","author":"Rizzo","year":"1995","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1007\/s002469900497","article-title":"Hemodynamic abnormalities in fetuses with congenital heart disease","volume":"20","author":"Lutin","year":"1999","journal-title":"Pediatric Cardiology."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1532-429X-15-65","article-title":"Fetal circulation in left-sided congenital heart disease measured by cardiovascular magnetic resonance: a case\u2013control study","volume":"15","author":"Al Nafisi","year":"2013","journal-title":"J Cardiovasc Magn Reson."},{"key":"B21","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1007\/s00246-002-0404-0","article-title":"Autoregulation of cerebral blood flow in fetuses with congenital heart disease: the brain sparing effect","volume":"24","author":"Donofrio","year":"2003","journal-title":"Pediatric Cardiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1080\/00016340903214924","article-title":"Redistribution pattern of fetal liver circulation in intrauterine growth restriction","volume":"88","author":"Ebbing","year":"2009","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B23","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1530\/REP-18-0633","article-title":"Dysregulation of the placental renin\u2013angiotensin system in human fetal growth restriction","volume":"158","author":"Delforce","year":"2019","journal-title":"Reproduction."},{"key":"B24","doi-asserted-by":"publisher","first-page":"R227","DOI":"10.1530\/REP-16-0287","article-title":"Progress in the understanding of the etiology and predictability of fetal growth restriction","volume":"153","author":"Tang","year":"2017","journal-title":"Reproduction."},{"key":"B25","doi-asserted-by":"publisher","first-page":"S123","DOI":"10.1016\/j.ajog.2015.06.038","article-title":"Role of the fetoplacental endothelium in fetal growth restriction with abnormal umbilical artery Doppler velocimetry","volume":"213","author":"Su","year":"2015","journal-title":"Am J Obstetrics Gynecol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"390","DOI":"10.2174\/1389202915666140716175634","article-title":"Congenital heart disease: the crossroads of genetics, epigenetics and environment","volume":"15","author":"Vecoli","year":"2014","journal-title":"Curr Genom."},{"key":"B27","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1038\/nature14361","article-title":"The maternal-age-associated risk of congenital heart disease is modifiable","volume":"520","author":"Schulkey","year":"2015","journal-title":"Nature."},{"key":"B28","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1002\/bdra.20761","article-title":"Maternal DNA hypomethylation and congenital heart defects","volume":"91","author":"Chowdhury","year":"2011","journal-title":"Birth Defects Res A Clin Mol Teratol."}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.676994\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T04:48:54Z","timestamp":1622177334000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.676994\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,28]]},"references-count":28,"alternative-id":["10.3389\/fped.2021.676994"],"URL":"https:\/\/doi.org\/10.3389\/fped.2021.676994","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,28]]},"article-number":"676994"}}