Malnutrition in children with congenital heart diseases

Abstract EN

Objective : a case-control study was carried out to assess the nutritional status of infants and children with congenital heart diseases, and study selected variables as age, sex, types of congenital heart diseases, and family history in relation to the nutritional variables of patients who were admitted to Basra Maternity and Children Hospital and Basra General Hospital from October 2014 till April 2015.

Methods : detailed history was taken from all patients including; identity, presenting symptoms, age at diagnosis and type of congenital heart diseases, treatment and feeding history as well as echocardiography reports were anthropometric measurements were carried out for all infants and children recruited in the study.

Nutritional status was assessed based on WHO/National Center for Health Statistics, and malnutrition was considered when : weight for age, weight for height/length and height for age Z score ≤ -2, as well as proportions of underweight, wasting and stunting were assessed.

Results : a total of 54 patients with congenital heart diseases were included in this study; 33 (61.1%) were males and 21 (38.9%) were females, and 58 infants and children were aged and sex matched as a control group.

The mean weight, height/length and head circumference of patients with congenital heart diseases were (7.1 kg, 66.8 cm, 41.8 cm) respectively; which is significantly lower than control group (9.9 kg, 75.7 cm, 44 cm), p-value<0.05.

Current study revealed that; 44.4% of patients with congenital heart diseases had wasting and 38.9% had stunting with significant p-value=0.000.

The wasting was more common in infants and children with acyanotic congenital heart diseases (63.3%), while stunting was more in cyanotic congenital heart diseases (70.8%).

Wasting and stunting significantly were more common in patients kept on anti-failure therapy (37.0% and 29.6%, respectively) than those without medical treatment, p-value=0.000.

Only 5.6% of patients with congenital heart diseases seek medical advice for poor weight gain, and the majority presented with symptoms related to congenital heart diseases like breathlessness and cyanosis with p-value=0.001.

Conclusions : malnutrition remains a problem among symptomatic infants and children with congenital heart diseases, so particular attention is required for early diagnosis, medical and surgical intervention and dietary management of those children to restore normal growth.