Outcome and factors associated with undernutrition among children with congenital heart disease

Abstract

Background Congenital heart disease (CHD) is associated with high morbidity and mortality, especially among those with undernutrition. Evaluating risk factors associated with undernutrition is important to improve clinical outcomes. We aimed to evaluate the outcome and factors associated with undernutrition among children with CHD. Material and methods A prospective cohort study was conducted among children with CHD at Dr. Sardjito Hospital, Yogyakarta, Indonesia during February 2016 to June 2018. Clinical and demographic data were collected at the time of diagnosis. Multivariate logistic regression analysis was used to identify independent factors associated with undernutrition using odds ratio (OR) and 95% confidence interval (CI). Significance was set as p<0.05. Results We recruited 1,149 children with CHD, of those, 563 (49%) were underweight, 549 (47.8%) were stunting, and 361 (31.4%) were wasting. In the multivariate analysis, cyanotic CHD, delayed diagnosis, congestive heart failure, pulmonary hypertension, syndrome, young maternal age, history of low birth weight, and being first child were independently associated with undernutrition. Underweight and stunting were significantly associated with increased mortality with OR of 3.54 (95% CI: 1.62–7.74), p<0.001 and OR 3.31 (95% CI: 1.65–6.64), p<0.001, respectively. Conclusions About half of the children with CHD were categorized with undernutrition. An increased risk of undernutrition was associated with cyanotic CHD, delayed diagnosis, congestive heart failure, pulmonary hypertension, syndrome, low birth weight, and being first child. Underweight and stunting were significantly associated with increased risk of death.

Failure to thrive in pediatric patients with congenital heart disease: a cross-sectional study of 13,256 patients

“…Our study demonstrated that CHD patients with LBW were more vulnerable to FTT, which was in line with previous studies. 15 , 49 It is well recognized that neonates with CHD face an increased risk of LBW, potentially due to abnormal circulation during the fetal period. 50 Following birth, unstable hemodynamics can further impact the nutrition and oxygen supplementation until anatomical correction, which may worsen the somatic growth.…”

Association between type of congenital heart disease with child growth and development status: A cross-sectional study in Medan, Indonesia

“…Impaired growth is linked to adverse consequences such as increased mortality, extended hospital stays, delayed cardiac surgery and postoperative complications [ 23 ]. A study reported that underweight and stunting increased mortality with an odds ratio (OR) of 3.54 and 3.31, respectively [ 23 ].…”

“…Impaired growth is linked to adverse consequences such as increased mortality, extended hospital stays, delayed cardiac surgery and postoperative complications [ 23 ]. A study reported that underweight and stunting increased mortality with an odds ratio (OR) of 3.54 and 3.31, respectively [ 23 ]. Another study identified a correlation between low height-for-age and weight-for-age z-scores and post-surgery mortality in CHD patients [ 24 ].…”

Cumulative Dose of Prostaglandin E1 Determines Gastrointestinal Adverse Effects in Term and Near-Term Neonates Awaiting Cardiac Surgery: A Retrospective Cohort Study

“…Feeding intolerance, gastric mucosal hypertrophy, and NEC were reported as associated with feeding newborns with ductal-dependent heart defects preoperatively, while receiving PGE1 treatment [ 23 , 24 ]. However, adequate nutrition is crucial for infants with congenital heart defects, as many infants are considered malnourished at the time of cardiac surgery, more so infants with cyanotic heart defects [ 25 , 26 , 27 ]. Malnutrition in these infants is multifactorial, and is due to both decreased intake, as nutritional practices have great variability between centers, and increased energy expenditure, due to their basic disease [ 28 , 29 ].…”