Prevalence, Predictors and Profile of Malnutrition in Children With Congenital Heart Defects

Abstract

Background: Malnutrition in children with congenital heart defects [CHDs] has been linked to increased morbidity and mortality as indicated by frequent hospitalisation, poor surgical outcomes, persistent impairment of somatic growth and increased death. All types of malnutrition, and severe forms in particular, contribute to mortality in childhood. There is strong evidence that poor growth [ malnutrition] is associated with delayed mental development and poor school performance.The mechanisms for growth deficiency in CHD are multifactorialand include associated chromosomal anomalies/ genetic syndromes, inadequate nutritional intake due to feeding difficulties, and poor absorption of nutrients from digestive tract in chronic congestive heart failure. Also increased calories are required to sustain the increased myocardial, respiratory and neuro-humoral functions in CHD-related heart failure. Chronic CHF and chronic hypoxemia in CHD impair cellular metabolism and cell growth. Other mechanisms of growth deficiency in CHD have been reported.The WHO recommends the WHO/National Center for Health Statistics [NCHS] growth standards for nutrition surveys.The present study aims to describe the prevalence, profile and predictors of malnutrition using recommended case definitions.The findings of present study could be applied to current and future paediatric cardiac care practice. Aims And Objectives: To investigate the prevalence, profile, predictors and epidemiological pattern of malnutrition in children with congenital heart defects. Materials And Methods: This was a Case-control, observational study which was conducted in post graduate department of paediatrics GB Pant Children Hospital on all patients above 6 months of age admitted in the hospital as cases of congenital heart defects and controls will include the patients with minor ailments admitted for short stay. Study was conducted between December 2020-November 2022 Stastical Analysis: Data was entered in a Microsoft Excel spreadsheet. Categorical variables were summarized as frequency and percentage. Continuous variables were summarized as mean and SD. Results: The study was conducted on two hundred and fifty cases of CHD. The detected cardiac anomalies were classified as acyanotic heart diseases (n=163 65%) and cyanotic heart diseases (n=87 35%). The prevalence of CHD-related malnutrition was 90% as compared to 21.2% in the control patients with 63.3% of cases having severe malnutrition. Among cases, the relative proportions of wasting, stunting and underweight were 40.8%, 28.8% and 20.8%, respectively. Wasting was proportionately higher (58.3%) in acyanotic CHD, while stunting was predominant (67.8%) in cyanotic CHD (p=0.0001).