Long-term growth of children with autoantibody-mediated congenital heart block

Aim To analyse growth of children with and without congenital heart block (CHB) born to anti-Ro/SSA positive mothers from birth to 18years of age, using a population-based cohort of Swedish CHB patients. Methods Medical records for siblings with (n=72) and without (n=60) CHB born 1973-2009 to anti-Ro/SSA positive mothers were retrieved from child healthcare centres and school health services and used to extract data on growth from birth to 18years. Results Compared with reference standards, children with CHB were retarded in weight by 0.75-1.0 SD from birth to 2-3years of age. Thereafter, the CHB children started to catch up, reaching the reference standards at 9-11years of age. Pacemaker treatment was not correlated with the catch-up in growth. Individuals with CHB were retarded in both weight and height from birth to 9-11years of age when compared to siblings without CHB, who did not demonstrate restriction in these measurements. Conclusion Presence of CHB is a more important predictor of growth restriction than maternal rheumatic disease and foetal anti-Ro/SSA exposure. The restriction persists for several years after birth, despite pacemaker treatment, which highlights the importance of follow-up of children with CHB regarding nutrition and growth.