Postnatal Linear Growth of Infants Born with Persistent Foramen Ovale (PFO) associated with Small Left to Right Shunts that did not Require Surgical Interference

Patent foramen ovale (PFO) is a common finding in the general population with a prevalence of about 25%. Isolated PFO is not usually associated with slow growth during the infantile period. However linear growth in infants with PFO associated with other small to moderate left to right shunts have not been well-studied.

Aim: We evaluated growth of 17infants born with PFO associated with other left to right small to moderate shunts who did not require surgical interference. Methods: The growth data of 17 Infants with PFO associated with other left to right small to moderate shunts(11 with small PDA and 6 with small VSD) who did not require surgical interference were recorded regularly every 3 months for 18-24 months. Growth data included length, weight, weightfor age SDS (WAZ), Length SDS (LSDS), and weight for length SDS(WLZ).

Results: Seven infants crossed down length centiles by 1SD or more and 5 crossed up centiles by 1SD or more during this period. 4 /17 infants had LAZ < -2 at 1.6 years. Two of them had PFO + muscular VSD and 1 had PFO + moderate size PDA. Six infants had increased WAZ and 3 infants had decreased WAZ by 1 SD or more during the follow up period.

Conclusion: Slow infantile linear growth occurred in 4/17 of infants who had PFO associated with other small to moderate left to right shunts despite normal weight gain. Regular postnatal linear growth assessment is advised in these infants.